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About body

Understanding the basics

When it comes to sex, many of us are aware of our anatomy but we often over-simplify what goes on beneath the surface of our bodies. Some of us still talk about things ‘down below’ and while there’s a certain quaintness about using such terms, they are inaccurate and misleading.

An informed working knowledge of the parts of the body used for sex can give greater control over what we do sexually, and help put sexually transmitted infections (STIs) and other problems in context. For example, did you know that pain while getting fucked is often due to the cock ‘prodding’ nerve endings at the base of your spine or sensitive arse muscles inside your body? The pain will often go if you change the position or relax the muscles.

And when it comes to the basics of all the other ‘stuff’ we can get stuck quickly, so we’ve included sections on

DIY check-ups

grooming (looking good)

nutrition and exercise

sleep

mental health

It’s all connected and while we are hardly the ‘experts’ we’ve tried to provide a basic understanding of pieces of the puzzle, together with some tips, to help you remain healthy, happy and horny.

Cock and balls

Cock design

The cock is made up of three inflatable cylinders of a honey-combed spongy tissue, two on the upper side (as you look down at it) and one on the underneath. When your cock is soft the cylinders are like long flat balloons. The vein that you can see running down the top of your cock pumps blood into these balloons when you get an erection. Down the centre of the cock is the urethra, the tube through which we piss; more of this later.

Every one of Laura Dodsworth’s penises is unique: introvert and extrovert, straight and bendy, wobblers and bobblers, growers and showers. There are contented penises that have led full lives, and disappointed penises that have let down their owners – or been let down by their owners.

In Dodsworth’s new book Manhood, every penis tells a story. There is the trans man who invested in the biggest and best; the underpowered poet hung up on his for years, until he decided to celebrate it with The Big Small Penis Party; the man who as a teenager thought he had genital warts and considered killing himself, until he found out they were normal spots; the business leader whose small penis taught him humility; the sex addict whose wife tried to cut it off; and the vicar who enjoyed his first threesome while training for the priesthood.

Cock size

For centuries, men across the planet have placed great importance on penis size with many cultures equating size with masculinity and symbolising qualities such as virility, fertility, strength, ability and courage. However, a few/ some/ all men [delete which don’t apply] worry that their cock is smaller than it should be or that it won’t satisfy.

As a result of an recent International study of more than 15,000 penises around the world, we now have a scientific answer to this enduring question. For the average man:

For those of you who have no idea what inches are explore here. Fractions are displayed as ¼, ½ and ¾ of an inch; but also as eighths: 1/8th, 2/8th, 3/8 etc; and sixteenths: 1/16, 2/16, 3/16 etc. Inches are sometimes denoted as double quote marks after the number so six and a half inches would look like this: 6½” You can find a handy cm/mm to fractions of an inch calculator here. Although the introduction of the metric system makes calculations easier, cock size measured in inches remains prevalent, like the pint. While we love centimetres “Why don’t you suck off my 7 inches” sounds that little more appetising.

Given only the first couple of inches (or first few centimetres) of the arsehole is touch-sensitive, a shorter or thicker cock can be just as good at stimulating those nerve endings as anything larger. While big long cocks can have your arse poked skywards in seconds, they can knock into the rectum wall and sphincter muscles causing discomfort and pain. So the moral of this tale is quite simple: don’t ignore smaller cocks and beware of bigger ones in the hands of dickheads who think they know what they’re doing.

Also, you can’t judge the true size of a penis while it’s soft or not erect. Some men with relatively small penises grow to a larger size when erect, while their larger counterparts don’t show as much growth when hard. Thus the term: ‘grower or shower.’ Peaking sideways-on at his dick at the urinal gives the impression of greater length, unlike when you are looking downwards at your own.

For better and worse, gay men have turned size into an art form. It’s a major currency among gay men and threaded though our culture, our scenes, our community and whatnot, and a core part of who we are as men who fuck other men. A pre-requisite box on many (if not all) gay hook-up apps and websites, porn websites don’t miss a trick either with dedicated categories: big dick, massive monsters, donkey dicks, over-sized dicks, destroyer dicks. It’s difficult to know whether to wince or cry.

There isn’t a single person on this planet that hasn’t heard general statements relating penis size to race and ethnicity. Though in some cases the generalizations are true, they are merely stereotypes. There are men in all ethnic groups that negate such generalizations. In other words, don’t judge a book by its cover! You may be disappointed with the results… or pleasantly surprised.

“Guys with dicks are so demanding. You want to slap ’em.”
“If it’s more than a mouthful then it’s a waste.”
“I know mine is smaller but you adapt. I mean, so many men.”
“Guy’s don’t want me, they just want my dick. Fun for a while, but then it’s depressing.”
“You think it’s easy staying hard, satisfying all these arses. I need a spa and a splint.”
“I just care who it’s attached to.”
“I care about if they know how to use it or not.”
“I wish mine was smaller. I scare people off.”

Curved penis

It’s common for the penis to curve slightly to the left or right when it’s erect. But if you have a more significant bend in your penis this may cause pain, difficulty having sex, and/ or erectile dysfunction. These can sometimes be symptoms of Peyronie’s disease, a condition caused by scar tissue, called plaque, that forms inside the penis. However, most men with Peyronie’s disease can still have sex.

According to the British Association of Urological Surgeons (BAUS), Peyronie’s disease affects approximately one in every 16 men (6%), however many urologists believe it’s under-reported, possibly affecting as many as one in 10 men (10%). Most men affected are over the age of 40.

Many men don’t need treatment, as they don’t have pain or the condition doesn’t affect their sexual function. The condition can sometimes improve without treatment. Various non-surgical treatments are available, including medicines and injections of steroids into the affected area. But there’s limited evidence of their effectiveness. Surgery may involve:

removing or cutting away the plaque and attaching a patch of skin or a vein to straighten the penis

removing an area of the penis opposite the plaque to cancel out the bend (this can lead to a slight shortening of the penis)

Foreskin

The end of the cock is covered by a sleeve of stretchy skin called the foreskin. It protects the cock while soft, keeping it moist and sensitive. When we are born, the foreskin is usually stuck to it until we are about 3-4 years old when it starts to peel back by itself. By the time we are in our teens it can be pulled back and forwards without any problems.

A related condition, paraphimosis is when the foreskin gets stuck in the pulled-back position causing pain and swelling. Some larger foreskins catch piss as it comes out of the urethra, where it can then remain trapped and lead to dribbling when you think you’ve finished.

Getting into the habit if pulling the foreskin right back every time you piss followed by a thorough shake and squeeze is the obvious solution.

Again, don’t suffer: head off to a sexual health clinic, or GP, to get it sorted!

When men are circumcised (usually as new born babies) the foreskin is surgically removed. While the principle reasons for this are religious grounds and to improve personal hygiene, as was mentioned earlier, men with excessively large or tight foreskins are often treated by circumcision.

Although the vast majority of American men are circumcised, more recently, circumcision has decreased in popularity and, in the UK, circumcised men are in the minority. After circumcision, the head of the cock loses its soft moist texture and becomes darker, tougher, dryer and more like normal skin.

Understandably, men can lose some sensitivity and it can take a long time to cum (not that it‘s necessarily a problem). If required, techniques can re-develop a circumcised foreskin, particularly if the foreskin has been mutilated by poor circumcision. A specially shaped plaster will encourage the skin to re-grow (over several years) and skin grafts can also restore the foreskin.

Smegma

Smegma gets a very bad rap, which not fair because we need it!

The dick produces it to keep the dick head moist. It’s a natural lubricant which reduces the friction between the foreskin and the dick head (glans) allowing the foreskin to be pulled back and forth smoothly, and smooth movement between them during sex.

In its fresh wholesome state it’s the functional lubricant as nature intended. If it’s allowed to build up, however, it changes into an unpleasant bad-smelling creamy substance made up of stale piss, bacteria, yeasts and discarded skin cells. This is the bit we tend to remember!

Excess smegma leads to irritation and soreness which is why you should clean beneath the foreskin (gently but thoroughly) at least once a day.

“Could these movements be comfortably performed if the surfaces between glans and foreskin were dry and harsh? Of course not. There would be difficulty, delay, and need for manipulation. Nature has therefore provided a ‘natural ointment’, smegma to ensure easy lubrication and protect this delicate region of the male genital organ.” | Joyce Wright, MD | Sexology (New York), vol. 37, no. 2: pg: 50-53. September 1970.

Washing dick

Washing your dick and balls daily – as part of your shower or bath routine – should be sufficient to maintain good hygiene. And while you’re there don’t forget your arse, arse crack and arsehole.

It’s beyond us where men get this strange idea that for something to be clean it has to be scrubbed to within an inch of its life. (You are not cleaning the dog or the oven). Being gentle but thorough is much more important than scrubbing vigorously.

You should be cleaning the outside only, not ferreting around where you shouldn’t be. Trying to clean inside your dick (urethra) or inside your arsehole can cause irritation and be dangerous.

Many men use lashings of warm water and a thorough but gentle technique. However, if you are using soap, it should be mild, un-perfumed, and you may wish to consider one that is a pH balanced.

Your skin has a pH level of around 5.5. The pH level of most skin cleansers tends to be a little higher so it can break down the dirt and oil on your skin. However bar soap, for example, can have pH levels of 9+ which is too high if you’re trying to keep your skin moist.

In warm water the cock and ball sack should be soft and stretchy, which also makes it easier to gently pull back the foreskin to clean. Only pull the foreskin back as far as is comfortable and take extra gentle washing if you are uncircumcised.

When you are done, gently return the foreskin to its natural position and pat dry with a clean towel (not one you’ve picked up off the floor).

Tempting though it may be, do not talc or use deodorants as they can cause irritation. Besides, fresh ‘au naturel’ is both manly and stunning!

Erections

An erection (hard-on, stiffy, boner) is not under our voluntary control in the same way as we can pick something up or wiggle our toes. It is caused by emotional, physical and hormonal signals in the form of electrical impulses which pass near the spinal cord and trigger an erection.

As we grow more sexually aware and experienced we accumulate a library of triggers or reminders which turn us on sexually: a look, body odour, being stroked, or the sight of a shaved head, for example. What turns us on is very personal to each of us, and during our sexual lives most of us will have at one time or another been surprised by something which, unexpectedly, has given us a raging hard-on.

When you get an erection, the cylinders in your cock fill with blood making it hard. Minute valves regulate blood into the cock when you get an erection, locking the blood inside while it’s stiff, and releasing the blood back into the body when it goes soft again.

There is also a misconception that as you get older you lose the ability to get or maintain an erection. It’s true that it can take longer to get turned on, and that physical reasons why you might not get one are more likely the older you get. But many men don’t see this as a problem and recognise that as we go through life our body and its needs change.

Curved erections Peyronie’s disease

Some guys get an erection that curves. This is caused by excess fibrous tissue on one side of the cock preventing it from becoming fully erect. The expansion of the cock on the other side then forces the erection to bend one way. In most cases the curvature is minimal and doesn’t cause any discomfort or problems – it just looks as if it’s got a mind of its own.

Cast your eye back over a few dicks and you’ll probably remember a few bananas requiring some oral massage! However, the curve can be so severe that it causes pain and fucking is not possible. The angle of curve can decrease without treatment but medication and/or surgery may be required.

A persistent erection – not connected with sex – is called priapism. The condition can be extremely painful and usually occurs when blood fails to drain out of the spongy tissue inside the cock. In some cases the cock will start to go blue! Urgent medical treatment at an accident and emergency department is usually required immediately.

An overly tight cock ring which you can’t remove while you have an erection can cause similar symptoms. If it’s made of rubber you can cut it off – carefully. Metal cock rings, however, are more problematic and the fire service has been known to have been called out. (Trying to remove it with a blow torch is not recommended!)

“My partner and I went to a pool party. Suitably high, our host went online and invited over another guy who stripped off and jumped in the pool. No need to guess what happened next! The guy said that he liked his dick to be really hard during sex, so he injected it with a clear liquid. He was very careful, and had all of the medical equipment, clean syringes, antiseptic spray etc. My partner was fascinated and asked if he could have it done too. The guy obliged. After a lot of fun sex we left the party and went home to bed.

The next morning my partner’s cock was still rock hard and showed no signs of going down. He did some research online and got worried, and so we went to A&E. The doctor saw him straight away (so thankfully no wait). When she asked what the liquid was and how much was injected we had to admit that we didn’t know… and we felt like stupid kids. They put him on an anti-inflammatory drip and drew blood from his arm to lower his blood pressure… but his dick stayed up like a flagpole. So then they drew blood from all around the base of his cock, after warning him that there was a chance he may never get a full, solid hard-on again – my partner is a ‘top’ and so this was really unwelcome news. The erection wavered briefly, but then arose like a phoenix! After that they told us there was no choice but to operate, and took him to the Intensive Care Unit.

Maybe it was the fear of an operation, but after being wheeled into the ICU (dressed in the usual ‘flattering’ backless gown) his dick finally became softer and so the doctors decided there was no need to operate after all. A relief, of course, but my partner’s dick was really bruised and sore. They kept him in hospital overnight for observation, and administered more anti-inflammatory and saline drips.

Back at home, his cock was tender for many days afterwards, and still now feels different (lumpy) around the base from where they drew a lot of blood. After some very tentative, and frankly painful sex (for him), it turns out that his erections are still strong and his cock works fine: good news for us… but we certainly learnt a lesson the hard way (pun intended!).

Impotence

The truth is that most men will experience impotence at some time or another. It’s a fact of life, it’s not uncommon and it’s often temporary. Not being able to get an erection (or ‘get it up’) is usually referred to as erectile dysfunction or impotence.

Physical impotence

This is usually the result of exhaustion, stress and anxiety, recreational drugs or too much alcohol. Other reasons include:

If you can get an erection but not necessarily when you want to, the problem is likely to be a psychological one. Reasons are likely to include lack of sexual stimulation, fear of performance, low self-esteem, stress and depression.

It may sound obvious, but if you’re not turned on you’re not likely to get an erection. For example, you may not find someone as attractive as you used to, or something which once aroused you sexually may have lost its allure (which is one of the reasons why we experiment sexually).

The significance we place on sex, performance and physical perfection creates high expectations – of ourselves and our partners – which can be impossible to meet. Consequently, a fear that we cannot perform adequately can affect our ability to get a hard-on, although it doesn’t mean you don’t feel horny. This can make the situation doubly frustrating.

Physically, if we’re uncomfortable with our bodies or the way we look, or if we don’t feel good or relaxed about ourselves, getting an erection can be a major problem. Ironically, beauty is in the eye of the beholder, and what turns you off about yourself can easily turn someone else on.

Steps to solving impotence

Embarrassment prevents many men from seeking help, making them miserable and putting strain on their personal and social life. Acknowledging that there is a problem is the first step. In the first instance, it can be helpful talking it through with a friend or your partner, difficult though this may be.Then you should visit your sexual health clinic or GP. Determining the source of impotence will determine treatment, which include changes to existing medication (if you are taking any) additional medication and/ or counselling/ therapy.

PDE5 inhibitors

PDE5 inhibitors help the body’s natural response to sexual stimulation by blocking an enzyme in the smooth muscle cells in the cock. Brand names include Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) and Stendra/ Spedra (avanafil).

DO NOT use poppers and PDE5 inhibitors

While we can see the appeal of intense feelings of horniness and a raging hard-on, the combination can make your blood pressure drop dangerously low, resulting in dizziness, fainting, heart problems and potentially a coma and/ or death.

Vasodilators

Vasodilators are a group of drugs which can increase blood flow by expanding blood vessels, increasing the blood flow to the cock, and giving you an almost instant erection. The drug is identical to a naturally occurring substance found in your body that helps keep the blood vessels open and increases blood flow. Brand names include Caverject® (a small injection in the side of the cock) and Muse® (a pellet inserted into the end of the cock).

Piss (pee, urine)

Our body continually produces waste, some of which is filtered out in liquid form as urine. Each of us produce about 1.5 litres (2.6 pints) a day which is sent from our kidneys to the bladder, a globe shaped organ, which holds about 400-800ml of urine. Sensitive receptors send signals to our brain as it fills up which we translate as ‘I need to piss soon/ now’. When we’re ready it’s channelled through the prostate, along the urethra, and out of the end of the cock through a series of muscles which control the flow.

Aim (no pun intended) to make your pee a light to pale yellow. Darker pee usually means you are dehydrated and, if it persists, other problems. If your pee is clear then you may be drinking too much water.

Eating asparagus is known to turn pee darker yellow or green; artificial food colouring can also turn pee green. Beets or beetroot, blackberries and rhubarb can make your pee turn red; or it could be blood. Get checked out if you have any doubts or concerns.

Balls (testes)

Your balls hang together, at slightly different heights, in a small stretchy sac. Their purpose is to produce and store sperm and testosterone. They are positioned away from the body, allowing air to circulate around the sac keeping the sperm-making facilities at their best, 5°C lower than the rest of you.

Your balls are so clued-up and manoeuvrable that they have the good sense to pull themselves into your body when it’s cold, stretch themselves away when you’re hot and have time to enjoy themselves being sensitive to licking, sucking and smacking.

Inside each ball are 500 metres of coiled up spaghetti-like tubing in which sperm are produced at a daily rate of 400 to 500 million. When they are ready, they are moved and stored for action in the epididymis situated behind each ball.

The balls also produce testosterone, a natural anabolic steroid hormone, which increases at puberty and causes the characteristic changes, eg: stubble, breaking of the voice, etc.

Cum (spunk, semen)

Cum is made up of sperm (made by the balls), the fluid in which they swim (made by the prostate gland) and a milky-creamy thickening agent (made by the seminal vesicles and bulbourethral glands).

The fluid contains nutrients to keep the sperm alive and kicking as they battle their way towards the female egg – they’re on a lost cause there then! These include zinc, potassium, glucose, and vitamin C which gives cum its sweet, salty and very individual taste.

As you’re preparing to shoot your load, muscle contractions pump the cum from the epididymis, along the vas deferens, into the urethra which runs along the inside of your cock.

Each time we cum, we release about 2-5ml (half a dessert spoon) which contain between 50-150 million sperm. When we cum repeatedly, we produce more fluid, less sperm – which is why it tends to be clearer and more liquid.

Sexual arousal in men

When a man gets an erection, his body goes through 4 stages of sexual response: arousal, plateau, orgasm and resolution.

Stage 1: sexual excitement or arousalA man gets an erection with physical or psychological stimulation, or both. This causes more blood to flow into 3 spongy areas called corpora that run along the length of his penis. The skin is loose and mobile, allowing his penis to grow. His scrotum – the bag of skin holding the testicles – becomes tighter, so his testicles are drawn up towards the body.

Stage 2: sexual plateauThe head (glans) of his penis gets wider, and the blood vessels in and around the penis fill with blood. This causes the colour to deepen and his testicles to grow up to 50% larger. His testicles continue to rise, and a warm feeling around the area between the testicles and anus (perineum) develops. His heart rate increases, blood pressure rises, breathing becomes quicker, and his thighs and buttocks tighten. He’s getting close to orgasm.

Stage 3: orgasm and ejaculationA series of contractions force semen into the urethra, the tube along which urine and semen come out of the penis. These contractions occur in the pelvic floor muscles, in the tube that carries sperm from the testicles to the penis (vas deferens). They also occur in the seminal vesicles and the prostate gland, which both add fluid to the sperm. This mix of sperm (5%) and fluid (95%) is called semen. These contractions are part of orgasm, and the man reaches a point where he can’t stop ejaculation happening. Contractions of the prostate gland and the pelvic floor muscles then lead to ejaculation, when semen is forced out of the penis.

Stage 4: resolution phase of sexThe man now has a recovery phase, when the penis and testicles shrink back to their normal size. He is breathing heavily and fast, his heart is beating rapidly, and he might be sweating. There’s a period of time after ejaculation when another orgasm isn’t possible. This varies between men, from a few minutes to a few hours, or even days. The time generally gets longer as men get older. If a man gets aroused but doesn’t ejaculate, this resolution stage can take longer, and his testicles and pelvis might ache.

Prostate gland

Situated next to the wall of the rectum, the prostate gland is about the size of a chestnut, and is connected to the bladder by one tube and to the urethra by another. While its purpose is not fully understood, amongst other things it produces the milky fluid in which sperm swim and live (making up about 30-40% of semen volume).

It also produces substances which give semen its characteristic smell and help pump the cum towards the end of the cock. It’s packed full of sensitive nerve endings which is why getting fucked or fisted can be a big turn-on.

Digestive system

Mouth and throat

Mouth and throat

Your mouth is the beginning of your digestive system. The throat is situated behind the mouth and joins the pharynx to the oesophagus, the tube which takes food to the stomach. The mouth is covered with soft mucous membrane and smooth muscle generally resilient to bacteria and other infections.

Our tongue is a multi-skilled muscle which helps us to speak, kiss, and taste and position food for chewing before moving it to the back of the throat for swallowing. But like every muscle, it can grow tired with over-use and can be strained, which is why prolonged cock sucking and rimming can be exhausting and no longer a pleasure.

The tongue is covered in taste buds which can determine four primary taste sensations: sour, salt, bitter and sweet. All other flavours such as chocolate, pepper and coffee are combinations of these four, accompanied by the sense of smell. The tongue has several taste zones: salty and sweet (to the front and tip of the tongue), sour (to the sides) and bitter (to the back).

Saliva

The mouth contains three pairs of saliva glands: beneath the tongue, on either side and to the top of the mouth. Chemically, saliva is 99% water and 1% a digestive enzyme and (in addition to chewing) helps to break down and lubri­cate food before swallowing. Saliva also destroys bacteria to protect the mucous membrane from infection and the teeth from decay. Saliva is produced continuously to lubricate the mouth and to keep the tongue and lips moist. During stress, the production of saliva decreases to conserve water. A dry mouth contributes to the sensation of thirst and drinking will not only moisten the mouth but also help restore the body’s water and chemical balance (homeostasis).

Gagging, coughing and choking

Sensitive muscles towards back of the mouth detect sharp, rough or large objects and will trigger the gagging reflex to prevent them from passing into the throat. The coughing reflex also aims to remove foreign or unwanted objects from the throat and oesophagus such as large or sharp pieces of food, dust and pollen.

Consequently, deep throat sucking comes with practice as you re-programme your brain not to reflex. It’s also worth remembering that when we swallow, a small flap (the epiglottis) in the oesophagus usually closes the opening to the larynx which leads to the lungs.

When food or drink ‘goes down the wrong way’, the flap doesn’t close in time and we start to cough to get it out of the air­way and back on track down the oesophagus to the stomach. Choking, on the other hand, is when we don’t get enough air and our body reflexes, demanding more.

End to beginning

Your arse is just the beginning – or rather the end – of your digestive system, which extracts nutrients and goodness from the food we eat. What’s left is waste which we get rid of as shit.

Many people believe that the digestive system is just a small tube linked to the stomach where shit sits and waits for the rectal express to the toilet. In fact, from mouth to arsehole, it’s a nine metre (30 foot) rubber-like tube, lined with muscles which massage the food and waste along, regulated by a series of locks and chambers.

Stomach

After swallowing, food travels down the oesophagus to the stomach – a ‘J’ shaped organ about 30cm long – where it stays for up to 6 hours. Here, acids and enzymes digest food until it becomes a semi-liquid soup which you have probably seen as vomit (with diced carrots).

The speed at which food moves on from the stomach depends on what you’ve eaten and what’s going on further down the line. Nerves which connect the arse to the stomach transmit messages to control the flow of food and waste. For example, you may experience discomfort or pains in your stomach if you are constipated or being fucked or fisted. Conversely, when you eat, you often want to go for a shit.

Small intestine

In a semi-liquid form, food is passed along the duodenum to the next stage of digestion: the small intestine, a long rubbery tube, 2.5cm (1”) across and some 6.5m (21‘) long. It’s here that the nutrients and goodness in food are extracted.

Large intestine

What remains resembles a rich vegetable soup, which passes into the large intestine. This is rather like an inverted ‘U’ shaped pipe which joins the small intestine at the bottom right-hand corner, near your appendix. This is made up of the ascending, transverse, descending, and sigmoid colons. It is here that the waste becomes more solid as the water and salt is absorbed back into the body.

The sigmoid colon is best described as the final packaging and holding bay for shit. The rectum is the dispatch area and the anal canal to your arsehole is the main exit. By the time shit leaves the sigmoid colon and reaches the rectum, it is normally produced in discrete turds of a soft consistency and reasonable size.

Rectum, anal canal and arsehole

Rectum

Around the connecting tube between your sigmoid colon and rectum is a ring of muscle that angles the tube in such a way as to close it off. This sphincter muscle regulates the shit leaving the sigmoid colon; without it, your rectum would fill up continuously and you would be shitting all the time. Your rectum is a stretchy four to five inch (10-13cm) muscular tube that can stretch to the size of a clenched fist (when full of shit) or a hand.

Anal canal and arsehole

Below your rectum is the anal canal, 1-2 inches (2-5cm) long which ends in your arsehole. The surface of the rectum and the anal canal is usually covered with a thin layer of mucus or natural lubricant designed to help with shitting and which also helps offer protection from infections. If you rub the surface, you quickly exhaust the supply of mucus which is why you need additional lubricant when putting anything up the arse.

At the bottom of the anal canal is another sphincter muscle made up of two smaller interconnected rings of muscle. One of them is not under your direct control but responds to internal body messages when the rectum is full or when you cough – the muscle tightens. When the muscle doesn’t work properly you leak. You have more control over the other muscle which you can relax or tighten at will. Try it now – you see control is everything!

Shitting

The weight of shit stretching the sides of the sigmoid colon signals the top sphincter muscle to relax briefly allowing a measured amount into the rectum. This is also called a movement. If you’re ready to go and sitting on a toilet, the bottom sphincter muscle relaxes and lets the shit down the anal canal and out through your arsehole.

Shit and poop

Over a lifetime, we each produce an average of 5 tons of poo but when it comes to shitting, having a poo, a dump, or crapping (whatever you call it) we can get surprisingly coy and embarrassed.

It’s an essential bodily function, often ignored, and yet poo shape, size, colour, and consistency can tell a great deal about your health and how well your digestive system is working. Poo can also hold clues to more serious issues like infections, digestive problems, and cancer.

Whether your poos come too often or not often enough, it can make you uncomfortable, bloated, or even interfere with your body’s ability to absorb enough nutrients from your food. And staying regular is crucial for staying healthy as it plays a major role in how you feel physically and emotionally.

Gay men tend to be less embarrassed and knowledgeable because many of us also use our arses for sex. But, even if you don’t have botty sex this section is relevant for you too.

Size and consistency

The Bristol Stool Scale or Bristol Stool Chart is designed to classify the form of human faeces into seven categories. Sometimes referred to in the UK as the ‘Meyers Scale’, it was developed by Heaton at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997.

Mouth to arsehole, your digestive system is a continuous tube around 30 feet/ 9 metres long. From swallowing food to pooping, general consensus seems to be it takes 24 to 72 hours to digest food, though time varies from person to person and the food you eat.

The colour poo

If you have any concerns about the colour of your poos then see your GP. If this is just too embarrassing, or you don’t feel you have ‘that’ sort of relationship, you may find going to a sexual health clinic or A&E easier. In the meantime, we have compiled this guide which you may find helpful:

BROWN is the target colour because of stercobilin, a by-product of the haemoglobin in broken-down red blood cells; and bile, a fluid secreted into your intestines to help digest fat.

PALE CLAY coloured poos can indicate a lack of bile or can be caused by some medications

BLOOD in poos can indicate bleeding in the lower digestive tract or rectum so, if you’ve been fucked recently, the blood may be from this. However, it can be a symptom of cancer.

BLACK poos could be the result of iron supplements or black liquorice, it may be a sign of bleeding in the upper gastrointestinal tract.

Composition

Poop is largely made up of water (75%), the bacteria which digests the food; and fibre, fats, other cells and mucus. The reason you can see sweet corn in poop is because the outside of the corn kernel is made of cellulose, an indigestible plant fibre which passes though the digestive system.

Floaters

As you may know, denser and heavier objects sink in water while lighter gas filled objects float, and increased gas in poo allows it to float. Most causes are harmless and go away without treatment and are due to to what you eat, a change in your diet or a tummy bug (gastrointestinal infection). However, less commonly, it may indicate lactose intolerance, the inability to digest lactose which is a sugar found in dairy products, or suggest a more serious digestive condition such as ulcerative colitis, Crohn’s disease, or celiac disease.

Our poo tips

Don’t suppress the desire to go; if you need to poo: poo.

Ensure adequate intake of water/ water-rich foods

Eat a healthy diet with sufficient fibre

Eat regularly, don’t skip meals or overeat.

Eat adequate amounts

Exercise regularly

Drink plenty of water and non-caffeinated, non-alcoholic drinks

Work at feeling emotionally balanced

also

Ensure you’re getting the right vitamins – a balanced diet should provide this (eg: A, C and D).

Ensure adequate intake of healthy fats.

Build and maintain a population of friendly bacteria in your digestive tract.

Aim for a work-life balance that reduces stress – anxiety can play havoc with our your digestive systems; eg: bouts of diarrhoea and constipation.

Farting

The digestive system is one of nature’s marvels: an uninterrupted conveyor belt running 24/7 which release enzymes and hormones to extract the nutrients and goodness from the food we eat. What’s left is waste, which we get rid of as shit.

Gas

Gas is the air in the digestive system which leaves the body as burps or farts. Burping or belching come from the stomach which has a different chemical composition from a fart which has less atmospheric gas content (air) and more bacterial gas content.

Gas in the digestive system is usually produced by swallowing air, and the breakdown of foods by enzymes and bacteria in the gut (eg: processing undigested carbohydrates and proteins). These gases are primarily carbon dioxide, oxygen, nitrogen, and hydrogen; with smaller amounts of some methane and sulphur.

We have scoured the Internet and you can fart between a few times a day to 10, 20, 30, 40 times times, producing around .5 litre plus of gas, but opinions vary greatly.

Burping

Burping is generally caused by swallowing air when eating or drinking, or inhaling, and is usually a mixture of nitrogen and oxygen. Carbonated/ fizzy drinks (including beer) often make you burp (more) which is primarily carbon dioxide from the drink itself.

Farting

Out of idle curiosity searching on farting on YouTube yielded 650,000+ results (some of them remarkably homophobic but that’s not what the section is about). We all do it, we all hear them, and some of our ‘friends’ have turned it into an art form (Philip). And yet it can remain a surprisingly embarrassing topic, partly because people believe they fart more often than others (or maybe it’s because others are better at concealing them).

Skatole and indole which occurs naturally in shit (before you poo it out) also add to the stench of farts

Farts can travel up to several metres/ feet per second and can be silent or noisy depending on the speed of the gas leaving the body, the position of the arse cheeks and tightness of the arsehole sphincter muscle

The more constipated you are (with food fermenting in your digestive system) the more you will fart and the smellier they will be

Depending on whether you are the type of guy who takes ownership you can (1) blame your farts on the dog even if there isn’t one (Debrett’s A-Z of Modern Manners); (2) blame the person who has just left the lift if you’ve farted and someone else has got in; (3) offer them a face mask; or (4) ask them if they can do better.

And ‘yes’ it is true: farts can be lighted but we don’t recommend it as you can burn yourself and singe hair!

Sensation to enlargement, pain and touch

The rectum only senses enlargement and stretch, while the anal canal can sense temperature, touch and pain. This makes the anal canal more fun to play with than the rectum which will only notice if you stretch its walls. Above the rectum there are no receptors to sense pain or injury so penetration beyond this point is more risky.

Located to the front of the rectum (tummy side) is your prostate gland, doughnut-shaped and about the size of a chestnut. Stimulating or rubbing during sex can be a big turn-on which is why getting fucked in the right position can be so pleasurable. However, the prostate is very sensitive to pressure and harpoon guns!

Problems and complications

There are many factors involved in shitting properly and some of these can go wrong. If your sphincter muscles don’t seal properly then you may leak or shit yourself. Ulcers or a split in the anal canal may mean you get pain and a tighter sphincter muscle.

Diarrhoea

Diarrhoea is usually caused by an irritation of the intestine lining or infection in your small or large intestine. Quite simply, your body wants to get rid of the problem and, if it can’t vomit it out, it will shit it out as quickly as possible. The muscles which massage food through the digestive system go into over-drive (which is what can cause stomach aches, pain and cramps).

To help flush out the problem, the locks and valves regulating the flow open up; however, this also means that there isn’t enough time to extract the water from the waste and it’s at times like this that your bowels just open to release that all-too-familiar brown sludge. Oddly enough, we sometimes underestimate our body’s ability to deal with situations like this.

Generally, speaking, it is best to let nature take its course – not forgetting to drink lots of fluids (containing salt and sugar) to help wash out your digestive system and prevent dehydration. However, if symptoms persist, get it checked out.

Constipation may be caused by spasms in the large intestine, insufficient bulk or roughage in your diet, lack of exercise or stress. Shit passing through the colon, which extracts just enough water to turn the sludge into solid turds, can get stuck there and continue to dry out until they become hard and knotted. Shitting is then painful as the hardened turds rub abrasively against the walls of your colon, rectum and anal canal.

If you regularly use laxatives, you may damage the nerve supply to this area and then either get diarrhoea or constipation. If you experience anything out of the ordinary or have any concerns, go to a doctor. Prevention or early treatment is preferable to suffering, or getting serious complications needing surgery.

Haemorrhoids are veins near the surface of the bottom part of your anal canal that have become inflamed, forming pockets or mini-bags of blood. Initially, they’ll stay inside the anal canal but can, over time, get larger and are pulled towards your arsehole by the downward motion of shitting.

If constipated, straining makes them much worse. Sometimes they split open and can bleed, often quite profusely. Sometimes the blood work itself out of the bags back into the body and the haemorrhoids heal themselves.

Suppositories (bullet shaped tablets which you slide up the anal canal) or creams (which you rub onto the entrance of your arsehole) will often alleviate the discomfort and pain of shitting. However, if symptoms persist, it’s important that you get yourself checked out by a sexual health clinic or by your doctor.

Lowering stress levels, taking regular exercise and eating a balanced diet all play important roles in ensuring that your digestive system works well and is problem-free. Dietary advice to prevent constipation is based on the effects of certain foods being able to resist digestion. Such foods increase the weight (and volume) of shit, and are also able to bind water more effectively, forming a turd that is softer and easier to expel from the body.

Fruit and vegetables, both cooked and raw, whole-grain cereal products such as brown rice, wholemeal bread, flour products and whole wheat breakfast cereals are excellent turd-bulking agents and the maxim is the more the merrier. Pulses, such as lentils and beans, are also known to be effective, although the novice may become rather farty and will need to adjust intakes accordingly. The addition of bran to the diet (along with sufficient fluid intake) can provide some relief from constipation, although this should not be a substitution for a healthy diet.

Foodstuffs which are more likely to lead to constipation include dairy products, fatty foods and foods which have little or no fibre. If you experience pain, discomfort, if you’re not shitting softish turds regularly or if you have any concerns – visit your doctor. Some sexual health clinics offer advice and information on diet and healthier living.

Ball and prostate check-ups

Testicular cancer and ball check-ups

Testicular cancer is on the increase, mostly affecting younger men in their 20s to 40s. It’s easy to deal with when treated quickly so, in addition to regular sexual health check-ups, DIY ball checks can pick up early warning signs that something may be wrong.

DIY ball check-ups

Check your balls monthly in (or just after) a shower or bath when your ball sack is relaxed and stretchy:

Rest your ball sack in your hand, feel its weight and use your fingers and thumb to feel each ball. It is normal for one ball to be slightly larger and lower than the other.

Gently roll each ball between your fingers and thumb. At the top you will feel the tube which it is attached to, and the firm, bumpy area where it joins on. The rest should be smooth without lumps or swelling.

If you feel anything that seems unusual or that concerns you, go to a clinic or your GP.

Over time you’ll get used to how your balls look and feel. This way you will notice any differences and problems quickly. Though most lumps and bumps turn out to be harmless, you should get them checked.

Remember, the earlier testicular cancer is found, the easier it is to treat.

The prostate and prostate cancer

Early prostate cancer rarely causes any symptoms; these only occur at a later stage of the disease. The prostate-specific antigen (PSA) test may help to detect early prostate cancer, but because many small prostate cancers are not dangerous, it is not yet known whether early detection and screening are worthwhile for prostate cancer. Studies are underway to find out, but until the results are known, screening for prostate cancer is not be routinely offered in the UK. There are treatments for men with an enlarged prostate gland: contact your GP a sexual health clinic.

Situated just below the bladder, the prostate gland is ‘hooked-up’ to the plumbing along which your spunk travels. It is responsible for producing the fluid in which sperm swim and a secretion which keeps the urethra moist.

It gets bigger as we get older and can sometimes begin to squash the tube that takes piss out of the body.

It can become infected or inflamed, most common between 25-45 years.

It can get enlarged to the size of a small grape fruit if untreated.

Prostate cancer usually occurs to the over-50s but can happen earlier.

Signs and symptoms that something is wrong include:

Needing to piss often and getting little warning that you need to go.

Finding it hard to start or stop pissing.

Lots of dribbling at the end of a piss.

Finding it a strain to empty your bladder properly.

Leaking or dribbling piss.

Prostate cancer tends to affect men in their 40s onwards but can be treated effectively if found early. The symptoms above may point to prostate problems and are sometimes felt by men with prostate cancer, but not always. If you are aged 50 or over, you should have yearly checks which can be performed simply by a doctor or at a sexual health clinic.

Cancer

Cancer is abnormal cell growth and may develop for a wide variety of reasons, some of which are known and others that aren’t. Normal cells have certain limits to their growth, cancerous cells continue to grow without controls, eventually causing serious and life-threatening damage. You can’t ‘catch’ cancer and it is not a sexually transmitted infection.

Looking good

Hair

Like skin and nails, hair is made from keratin. Hair acts as a protective barrier. For example, eyelashes protect the eyes, hairs in the nostrils and ears trap and prevent the entry of foreign bodies, and eyebrows prevent sweat dripping into the eyes.

Attached to the base of each hair is a minute strip of muscle which is stimulated by cold or emotional stress. When the muscle tightens, the hair stands up trapping air and conserving heat. Each hair grows for up to five years before entering a ‘resting’ phase. As the growth stops, the hair falls out and after about three months a new hair begins to grow to take its place.

Obviously, the number of hairs varies between individuals but, on average there are about 100,000 hairs on your head and you might lose anything between 40-120 hairs a day. Colour is determined by how much pigment hair contains. As we get older, we tend to produce less pigment which is why hair goes grey.

Hair loss

The reasons for hair loss are various including physical ailments, skin conditions, allergic reactions, and mental stress. The most common type of hair loss is baldness which is caused by hormonal change in the body as we get older. Unless you intend to stick the bum of a Canadian beaver to the top of your head – get used to it, it’s a fact of life! Shorter hair – properly groomed – can be dead sexy in a man of any age. For some men, however, hair loss is a major upset particularly when their young. If hair loss causes you stress, depression or makes you feel inadequate talk to your GP before spending money on potions or transplants.

Dandruff

Dandruff is a common but relatively harmless condition where dead skin cells are shed from the scalp. This produces white flakes which are best noticed on dark suits. The usual cause is a scaly rash called seborrhoeic dermatitis that can also affect the chest, face and back. Treatment involves regular use of a medicated anti-dandruff shampoo from your chemist although a cortico-steroid or anti-fungal drug are sometimes required (through your GP).

Hair care tips

Shampoo your hair regularly to remove any build up of dirt and grease.

Nails

Like skin, nails are made from keratin and protect our fingers and toes from wear and damage. They also help us pick up objects and allow us to scratch the little bastard’s eyes out when he cheats. Just kidding! Fingernails usually take 5 or 6 months to grow from base to tip (just under a millimetre a week). Toe nails take twice as long to grow which is why we don’t have to cut them so often (though some men seem to forget about them altogether).

Damage and indicators

Nails are susceptible to damage through injury, pressure or crushing (in a door, for example) but more usually through bacterial or fungal infections and general illnesses. Brittle or ridged nails, black splinter marks beneath the nail itself, blue and green discolouration may be signs of vitamin deficiency and generalised disease.

Nail biting

Nail biting is a nervous habit. A badly-bitten nail is more susceptible to infections, pain and bleeding. The usual treatment is to paint the nails with a clear solution which tastes horrible, but this has obvious limitations. Examining why you bite your nails can be helpful in devising a strategy to break the habit. Perhaps the best reason for quitting is being able to see a full set of neatly trimmed nails – it will only take a month to see significant improvements.

HIV and other STIs

Unbroken nails and skin, particularly where they join, provide an affective barrier against infections such as HIV and hepatitis C. Broken, torn, ragged, ripped, or bitten nails can provide a route for infection with an increased risk of transmission if the surrounding skin is also damaged. Given that many/ most of us use our fingers for sex in some way, where bodily fluids like semen and blood are often present, keeping your nails and skin in tip top condition is an essential part of your sexual health.

Don’t bite your nails. It doesn’t just look tacky, it really shows you up when you’re holding a glass, shaking hands or he’s trying to suck your fingers romantically. (He may as well nibble them for you).

To protect against nail infection, wear rubber gloves when your hands are being continually immersed in water.

See a doctor if your nails become discoloured or brittle as this could be due to a fungal infection or vitamin deficiency (which are usually easily treated).

Feet and toenail tips

If you shower (rather than bathe) don’t forget to clean your feet, toes and toenails everyday, making sure your dry them properly, particularly between the toes.

If you are prone to bacterial or fungal infections there are a range of creams, powders and sprays from your chemist that can help combat this. Keep a separate foot towel (which you don’t use on your face).

Change socks daily to prevent foot odour.

Use a pumice stone to gently remove dead skin from the heels and balls of your feet.

Discard shoes that are worn beyond repair, or no longer fit properly.

Wear natural materials, such as cotton socks and leather shoes to reduce sweating. If you suffer from smelly feet, wear insoles made of activated charcoal, which absorbs sweat and odour particles.

If you develop a foot problem, such as a callous, bunion or verruca, see your doctor or chiropodist.

Eyes

Sight is the main sense we use to map, absorb and appreciate the world around us, enabling us to socialise, work, communicate and stay connected. And when it comes to men on men action eye contact, facial expressions (like smiling), gestures, body language are all part of cruising, that first date, or a glance across a crowded room (yup, it still happens).

Though it’s the first thing we see in the morning and the last thing we see at night, we rarely give our sight a second thought as how we would manage if we couldn’t see. It’s also difficult to appreciate the role it plays in our lives because it’s so tightly woven into our daily existence and we (rarely) have a way of comparing what life would be like without it. The closest some of us will get will be a power cut or getting lost on Hampstead Heath on a moonless night.

The eye

The eye is a fluid filled ball (vitreous gel) held inside the eye socket by delicate muscles, which control eye movement up, down, left and right. At the front of the eye is the cornea which helps you focus. (People who wear contact lenses place them on this part of the eye). Behind this is the iris which controls the amount of light entering the eye. In its centre, a small aperture (the pupil) widens to let more light in when it’s dark and narrows when there is bright light. A circular ring of muscle surrounding the iris relaxes and contracts changing its shape to provide additional focus. Light then passes through the fluid in the eye ball to the retina at the back where millions of sensitive cells convert light into nerve impulses. These are sent to the brain where images – including the words you’re reading now – are assembled into stuff you can understand.

Tears

Tears keep the cornea and conjunctiva (which covers the white of the eye and the inside of the eyelids) constantly moist. Blinking sweeps a film of tears across the eye, keeping the surface well lubricated and washing away dust and dirt. In addition to salty water, tears contain a natural antiseptic. Tears drain away through a single hole near the inner end of each eyelid into small tear sacs and then down through the nose which is why your nose runs when you cry.

Short and long sightedness

Short sightedness is when near objects can be seen clearly while objects further away (even by as little as 30cm) can appear blurred or indistinct. Short sightedness is usually caused by the eye being too long front to back (horizontally) and, as a result, images of distant objects focus just in front of the front of the retina. Conversely, long sightedness is when the eye is too short affecting your long distance vision. These conditions are usually treated with glasses or contact lenses and regular check-ups for this and other sight conditions is essential – even if you think you have 20/20 vision.

Contact lenses

Contact lenses have been around for just over 100 years, although Leonardo da Vinci was actually the first to describe the possibility of using them over 500 years ago. While there are different types of lenses, soft lenses tend to be the most popular because they are easy to wear from the start, but an optician will be able to recommend a lens best suited to your needs. The high water content in soft lenses (40-80%) allows more oxygen to reach the eye covered by the lenses and so they can be worn for longer periods. However, despite their obvious success, problems can occur such as:

Hard lenses that scratch the eye if they’re put in roughly or are worn for too long

Problems with tear production

Sleeping in lenses particularly after a long night out when you may be dehydrated. You sometimes have to peel the lens off the eye. This is not good.

Symptoms include:

Redness, stinging and a sensation of heat in the eye

Pain or prickliness in the eye

Lenses jumping around the eye

Increased mucus leading to cloudy or foggy vision

If you experience any of the above, stop wearing your lenses immediately and head straight for your optician or GP.

Conjunctivitis

Conjunctivitis is an inflammation of the eye causing a range of symptoms including redness, discomfort, discharge and a sensitivity to light. Most cases are caused by bacteria which are spread from hand-to-eye contact or by viruses (eg: cold or sore throat). However, an allergic response can also be caused by contact lenses and associated cleaning solutions, pollen and cosmetics.

While warm water will wash away the discharge and remove any crusts on the eyelids, the infection itself usually requires treatment with eye-drops or an ointment containing an antibiotic, antihistamine or cortico-steroid drug. The important thing to remember is to see your optician or GP as soon as you think you have a problem. (This doesn’t mean making an appointment in a week’s time.)

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Eye care tips

Whatever your age, get your eyes tested at least once a year – or sooner if you notice any change

Depending on how long you use a computer at work, you employer has a legal responsibility to provide you with an eye test

TVs are brighter than you might think; sit at least five feet away from the screen

When using a computer, rest your eyes every 15 minutes by focusing on something else. Every hour you should have a few minutes break away from the screen. This will help prevent eye strain.

If you’re using artificial light to read, ideally the light should shine on to the page from behind you

Hearing

For most of us, sound surrounds us everyday. It shapes and influences our lives, enabling us to socialise, work, communicate and stay connected with the world.

We rarely give a second thought to how we would manage if we couldn’t hear chat lines, app alerts, demands to fuck harder. There are sounds which relax us, stress us out or warn us of potential danger. Then there are everyday sounds we sometimes know but don’t know are there: a tune on a radio, bird song, an approaching train, the chatter of friends in the next room.

It is often difficult to appreciate the role it plays in our lives because it’s so tightly woven into our daily existence and we (rarely) have a way of comparing what life would be like without it.

Our ears are designed to pick up sound and convert it into electrical signals which can be understood by the brain. The outer ear catches sound waves and channels them along a passage to the ear drum, causing it to vibrate. Wax is produced naturally and, along with the hairs which grow at the entrance of the ear, traps dirt and dust particles.

On the other side of the drum is the middle ear in which three tiny bones transmit the vibration across a small air filled cavity to the inner ear. The middle ear is connected to the back of the nose by the Eustachian tube which acts as a drainage passage and regulates air pressure. It opens during swallowing and yawning allowing air to flow up to the middle ear and equalising air pressure on both sides of the ear drum. Without this, the ear drum cannot vibrate properly which is why our hearing can become dull or muffled when we have a blocked nose or experience a change of air pressure when flying, for example.

The inner ear is made up of the cochlea, a small snail-shaped organ filled with fluid, through which sound waves vibrate. Minute hairs are stimulated by sound and converted into electrical impulses which are sent to the brain. Attached to the cochlea are three fluid-filled semi-circular canals at right angles to each other that help maintain balance by detecting even the slightest body movement.

The human ear is able to hear different ranges of sound from around 20Hz (hertz) to 30,000Hz. The top note on a piano, for example is around 4,000Hz. Comparative noise levels are measured in Decibels (Db) and the chart below shows a range of noises. Risk of injury starts at 90Db and probable permanent injury from 120Db.

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Damage to hearing

Hearing may be damaged by exposure to very loud noises for a short period (such as an explosion at close range) or by prolonged exposure to low levels of noise (such as might occur in a machine room). The most likely risk to gay men is loud music in a club or through headphones and, frankly, it’s pretty stupid when it can be avoided.

Muscles in the middle ear normally respond to loud noise by altering the stiffness of the bones that pass the vibrations to the inner ear. This reduces their efficiency and dampens the intensity of the noise. When a loud noise occurs without warning, these protective reflexes don’t have time to respond and the full force of the vibration is carried into the inner ear causing severe damage to delicate hairs in the cochlea.

Occasionally, loud noises actually rupture the ear drum. More commonly though, damage from loud noises occurs over a period of time, with a gradual destruction of the hairs causing permanent hearing loss. Sound at 90Db+ may cause pain and temporary deafness lasting for minutes or hours. This is a warning that hearing may be damaged.

Tinnitus (ringing or buzzing in the ears) occurs after the noise has stopped and is an indication that some damage has probably been done. Prolonged exposure to loud noise leads to a loss of ability to hear certain high tones.

Later on, deafness extends to all high frequencies and just listening to somebody talking becomes increasingly difficult. Eventually, lower tones are also affected.

Protecting your hearing

Whatever your age, see you doctor immediately should you experience any of the following symptoms: difficulty hearing someone talk, regular use of TV subtitles, persistent earache or pain, an unexplained loss of balance, dizziness, a ringing or noises in the ear.

Ear protectors should be worn in noisy environments over 80Db – this includes clubs.

Wear ear plugs when you’re clubbing and listening to loud music. You may like to ask a club the maximum level at which music is played (but they probably won’t have the faintest idea what you’re talking about).

Many smart phones and personal players have limits on the volume control. While these can often be over-ridden, the manufacturer will state that it is at your own risk.

Ears are usually very good at cleaning themselves. If wax builds up you should see your doctor before you start poking around. If you’re used to using cotton buds, remember to be gentle! A punctured ear drum can cause permanent deafness.

Teeth and the mouth

Many of us take our teeth for granted. It’s often only nasty surprises at the dentist or a jolt that our breath will concuss a man that we start taking our oral health seriously.

Our teeth are an asset, vital to our quality of life. They provide self confidence, and allow us to feel more ourselves, particularly when we smile! In fact, when we’re happy, there’s nothing like smiling big! Our teeth may not be perfect, in fact it’s imperfections that give us character, but good oral hygiene is more about spending a few minutes each day to floss and clean than anything else.

A little about teeth

Adults have 28 to 32 teeth depending whether the person finally grows their wisdom teeth, which do not appear in everyone. In many cases, wisdom teeth don’t emerge fully from the gum because of over-crowding. Your dentist will determine whether they are best left alone or taken out.

Teeth are largely made up of dentin on the outside and a pulp on the inside where blood vessels and nerve endings are situated. The crown, or visible part of a tooth, is covered with about 2mm of enamel. Below the gum line, the root of the tooth is made from cementum. Both dentin and cementum are tough, bony substances.

Teeth are ‘glued’ by a special membrane that anchors them to the surrounding socket. Poor oral hygiene or the failure to clean and floss your teeth regularly weakens the mouth’s ability to fight off infections and the membrane that fixes your teeth to the sockets. Consequently, despite the best efforts of saliva, which is you body’s natural answer to bleach, you are more inclined to get mouth ulcers and bleeding gums – obvious gateways for bacterial infections like gingivitis and viral infections like hepatitis and HIV.

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Bad breath

Bad breath is caused by bacteria, tooth decay, smoking or rich and spicy food. It can seem particularly unpleasant when you wake up in the morning after you’ve been drinking the night before. During the night your body produces less saliva (a natural mouthwash) and a thin, creamy coating forms over your teeth, tongue and gums. Healthy bacteria break it down producing mild toxins which smell and taste horrid. However, in some cases bad breath can be caused by medication and stomach ulcers.

“We flirted along the South Bank, his cute arse just begging for it as he leant over the pier at Butler’s Wharf. There is nothing more intoxicating than the moment on a date when you know that after fucking each other’s brains out there will be something else to talk about. As we moved in for the first kiss, I reeled back from a tsunami of putrid toxins, lost my balance, and fell into his mouth. To make matters worse, my distress was plain to see and he looked about apologetically for a culprit. A dick shrivelled and cold pre cum was all that was left of the date and a memory, seared into conciousness, stepping into dog shit on my way to school, the heady aroma of gelatinous pooh taking my gag reflex to the next level.” Tony, London 2014

Plaque

Plaque is a sticky coating on the teeth made up of saliva, bacteria and particles of food. It is the main cause of tooth decay and gingivitis (an infection of the gums). If allowed to accumulate it will become hard and increasingly difficult to remove. Plaque begins to form within hours of cleaning and is responsible for the furry feeling of un-brushed teeth. If the gums are unhealthy the plaque tends to spread more quickly. The bacteria can also rapidly erode teeth enamel and voilà… a cavity! Or voilà, voilà, voilà… lots of cavities that need filling. Plaque should be removed at least twice a day using a toothbrush and dental floss.

Gingivitis

Gingivitis is usually caused by a build-up of plaque. It is thought that the toxins produced by bacteria within the plaque irritate the gums, causing them to become infected, tender and swollen. Gingivitis can also result from injury to the gums, usually from rough brushing of teeth or flossing as if you’re lassoing a steer. Healthy gums are pink or brown and firm. Poorly gums become a reddish-purple, mushy, shiny and swollen. The gums bleed easily during brushing and are often tender. Good oral hygiene is the main means of preventing and treating gingivitis – and not letting the plaque form in the first place. In some cases, a special mouthwash will ease the symptoms.

Tips for teeth

You should visit a dentist every six months. If not, or if you leave it until pain and discomfort occurs, you are storing up potentially horrific problems for later on.

Clean your teeth at least twice a day, ideally after each meal. This should take no less than 3-4 minutes.

Renew your toothbrush or electric toothbrush head every couple of months, or per instructions.

Skin

Covering the surface of the body and weighing over 4kg (9lbs), skin is the largest body organ. Made from keratin, a hard protein, it provides a barrier against the environment, bacteria and other foreign organisms and keeps many organs from falling through the skeleton. Just as well then. Self-repairing and self-regenerating when damaged, unbroken skin is waterproof and protects the body from exposure to the sun’s harmful rays by producing melanin, a dark pigment, which forms a layer to absorb ultraviolet light; this is why we tan in the sun.

Skin also plays a key role in controlling body temperature and water balance. For example, body hairs become erect in the cold trapping warm hair close to the skin, and sweat glands secrete sweat to cool the body when it’s too hot. Full of nerve endings, skin also helps us understand our surroundings as it constantly transmits information about touch, pressure, pain and temperature for the brain to interpret. So, in short: don’t leave home without it.

Skin is attached to deeper body tissues with elastic fibres called collagen which allows the body to grow and stretch. As we get older, those parts of the body which have been exposed to the ageing effects of sunlight (the face, neck and hands, for example) lose elasticity as the collagen fibres break down. This is what causes bagginess and wrinkles and turns some of us into prunes.

Since the purpose of skin is to protect us from the environment, it’s not surprising that – from time to time – it breaks down. While many skin problems are rarely life-threatening and are relatively easy to treat, their effects can be devastating, particularly if you suffer from recurrent episodes. That ‘hot date’ suddenly becomes a nightmare as you explode with spots or an unexplained body rash. Common skin problems include:

Acne (spots) – skin follicles blocked with excess sebum (which lubricates the skin) and infected with bacteria. Also known as white/black heads which usually affect men during puberty but can affect us later on in life as well.

Eczema or dermatitis – inflamed, irritable, flaky, dry skin sometimes caused by allergies, although in many cases the cause is unknown. However, skin tests can sometimes determine the cause.

Athlete’s foot – a fungal or bacterial infection causing itchy and sore skin between the toes usually associated with wearing shoes and sweaty feet

Unless you know the cause of your skin condition (and any appropriate treatment) seek professional help – probably your GP in the first instance.

If you are an acne sufferer – avoid greasy skin and hair preparations that clog up the pores making it more difficult for your skin to breathe properly. A chemist should be able to suggest acne preparations which can be helpful in mild cases.

If you suffer from eczema or dermatitis an inexpensive moisturiser can help ensure your skin doesn’t dry out.

Changes in your diet can reduce the problem; for example, some eczema sufferers find that reducing dairy products can help.

Stress can trigger or exacerbate skin complaints – consider learning a relaxation technique. Many skin conditions can be helped by some exposure to sunlight – but we’re not talking sun tanning or burning!

If you suffer from athlete’s foot, a range of over-the-counter creams, sprays and powders are available. Simply ask your chemist.

Body odour (BO)

Sweating is essential and about controlling your body temperature and stop you overheating. Each day, the body gets rid of 2-3 litres of water through 2 million sweat glands. That’s about a teaspoon or 2ml every minute so it’s not surprising that body scents and odours occur naturally.

Sweat itself doesn’t really smell unless you’ve been at the garlic, curries or alcohol. Body odour (BO) is when sweat turns stale – a reaction between fats and proteins in the sweat and bacteria that live on the surface of the skin. Having said that, some men prefer a strong ripe body odour to a less aggressive body scent.

Our natural body scent, often a musky smell on the skin, is an individual fingerprint of who we are. In moderation, it’s generally regarded as pleasant and we respond and get turned on by the right scent in others.

You also have sweat glands on your forehead, palms and soles of your feet which is why you can sweat a lot if you put on a woolly hat, or thick gloves. Your feet have around 500,000 sweat glands and unlike other parts of our body are usually covered and enclosed by shoes or trainers. When feet are not ventilated, trapped warm sweat is a breeding ground for very smelly bacteria.

Sorting out BO

Shower or bath every day to kill the bacteria on your skin; on hot days you may have to do this more often. Afterwards dry yourself and feet (between the toes) properly.

Gently but thoroughly, wash right under and around the armpits using an antibacterial soap (which should say so on the packaging). Avoid over-washing as this can remove healthy skin bacteria and make the problem worse.

Wear natural fibres, such as wool, silk or cotton which allows skin to breathe so sweat evaporates more quickly. Conversely, avoid synthetic and/ or tight fitting clothes which trap sweat.

Wear clean clothes, particularly underwear and socks; no buts on this one! If you don’t wear underwear, remember you will have wash your jeans/ trousers more often.

Make sure you wash your clothes regularly.

Use a deodorant or an antiperspirant after showering or bathing.Shaving your armpits will allow sweat to evaporate quicker, giving bacteria less time to break it down (though this may not be the look you’re after).Reduce spicy foods (eg: garlic, onions, curry or garlic) which make your sweat smell worse. There is also evidence that eating a lot of red meat and heavily processed foods can make BO worse.

Sleep naked!

Antiperspirants and deodorants

Most people think that antiperspirants and deodorants are the same thing, but the active ingredients differ. Experiment as you may find some more effective than others.

Antiperspirants work by reducing the amount of sweat produced by your body. Antiperspirants contain aluminium chloride, a chemical that reduces sweating, and often also contain a deodorant. Roll-on antiperspirants tend to be more effective if you sweat heavily.

Deodorants work by masking and/ or neutralising sweat smell with antiseptics against bacteria and can preferable because they don’t interfere with sweating.

Experiment with a few to find which type and method of delivery suits you best. Some can cause irritation and you’d be unwise to apply them to broken skin or on your cock and balls. If you still have a BO problem, chemists have stronger antiperspirants which reduce the amount of sweat you produce, but can cause skin irritation. Further problems: see your GP.

Feet

With over 25 bones and a complex structure of muscles, tendons and ligaments, your feet keep you upright and balanced for a lifetime and absorb the impact of your body weight whether you’re walking or running.

And yet, our feet are probably the last thing we think about until they start hurting or when we expect someone to hold them, rub them or lick them. In fact, when it comes to our health routines, feet and toenails often fall to the bottom of the list.

Problems include odour, fungal infections, cracked skin, calluses, corns, and ingrown toenails – many easily avoided. So, here are our top tips for keeping the skin, bones and muscles of your feet functioning properly. However, if you have any concerns see you GP pronto.

WashingWash your feet every day gently but thoroughly with soap and warm water to get rid of dirt, sweat and bacteria, including the eight spaces in between your toes. Don’t forget to dry them properly. And feet can be ‘forgotten’ if you shower, particularly in cramped spaces where you can’t bend down. Also, if you tend to bath or shower in the morning you may be taking dirt into the bed with you at night.

MoisturiseMoisturise your feet regularly as there’s nothing worse than dried or cracked feet. Cocoa butter is good, for example, a natural emollient. If they’re particularly dry consider rubbing in some lotion or petroleum jelly at night bed (then putting on socks to protect the sheets). It will leave them soft but take care not to over moisturise between the toes which can lead to fungus.

Fit your feetYour feet will perform better if your shoes (including sandals or trainers) fit and support your feet, keep them dry and clean and allow them to breathe at a comfortable temperature. For example, tight shoes cause hammer toe, corns, ingrown toenails and general pain while overly large cause blisters and calluses, sore heels and excessive shoe wear. Also, synthetic materials tend not to breathe as well (trapping heat and moisture) while natural materials like leather and cotton will keep your feet cooler and release moisture. Athletic shoes with specialist materials or mesh can work even better.

Rotate your shoesYou can’t avoid foot sweat, but you can try to alternate your shoes so that the pair you wore yesterday has a chance to dry out completely before you wear them again. If you wonder why your trainers smell so rank (maybe a mate has had the decency to tell you) it may because you’ve been wearing the same pair.

Change your socksChange your socks daily; not every 2nd or 3rd day from a pile in the corner! Change your socks more often if you feel they are damp or sweaty; maybe taking an extra clear pair with you for when you finish at the gym. Socks made of natural fibres like cotton or wool draw moisture away from your feet while high-performance socks made of synthetic materials can do the job better because the material doesn’t compress as much when saturated with sweat.

Keep shoes cleanAvoid putting clean feet into shoes with dried sweat and bacteria. This can be difficult when you’re slipping on the same trainers everyday, but each time you do this makes the problem worse. Some guys will pop trainers into the washing machine (once in a while at a low temp wash) but don’t come running to us if they fall apart. You have been warned and it’s your call. Sometimes it’s just time to buy a new pair.

Changing roomsIt’s the place where feet meet so take precautions so you don’t end up with someone else’s foot fungus. Changing areas are typically damp environments next to showers so a haven for fungus and bacteria. It’s notoriously difficult drying feet properly in a public changing area before putting on socks and shoes. Some guys wear flip flops, and try not to share with others; eg: if a guy lends you his towel, how do you know he’s not used it on his feet first? Are you going to ask him?

Foot fungusAthlete’s foot and other foot fungus just lurve to grow in damp, moist environments. Deny them this and it’s probably our top tip when it comes to prevention. We’re putting it at the bottom because if you follow the steps above you will all but eliminate the likelihood of getting an infection.

Piercings

These days, nipple, ear, navel and eyebrow piercings are relatively common. Nipple piercing goes back thousands of years and is believed at one time to have been a sign of allegiance and manhood within Caesar’s Pretorian Guard. Many Roman statues are thought to show pierced nipples, but they could be representing a lorica or breastplate. There are even suggestions that cloaks were fastened to them. If true, they would have been very lightweight particularly when in battle – for obvious reasons!

Genital piercings (through the cock and balls) also have a long history. The ampalang (a barbell placed horizontally through the glans) comes from Borneo, where the women of certain tribes will not marry a man who does not have one. This and other piercings like the hafada (a ring through the ball sac) were considered rites of passage by some cultures, to mark the passage of a boy to a man.

The Prince Albert (a ring passing in through the urethra and exiting at the back of the glans, underneath and to one side or other of the frenum) has a more intriguing origin. During the Victorian era, the bulge of a cock in a man’s trouser was considered unsightly. This piercing could be used to strap the penis in place which is where the saying ‘…on which side does Sir dress’ is thought to originate. It is also rumoured that Prince Albert wore one, hence the piercing’s name. While genital piercings have become popular with some gay men, they are still a relatively small group, even though in some ‘specialist clubs’ you could be forgiven for thinking that you’d walked into an armoury.

Part of the pleasure of piercings has to do with the subtle sensations of wearing them, and there is no doubt that these types of piercing can be strikingly visual and a real turn-on, both for those exhibiting them and those admiring them. What you can have pierced will depend on your anatomy. A good body piercer should be able to advise you as to what will suit and the types of jewellery that will be most comfortable or visually striking.

Choosing your piercing

The barbell, the ball closure ring and banana bell (with equal sized balls) are not unusual. Normally a barbell in any body piercing will heal quicker than a ring, as there is nothing sticking out to catch or rub on clothes. Only jewellery made from highest grade surgical stainless steel or solid gold should be worn in a piercing. Silver and other metals which can tarnish should never be used.

The important thing is to discuss what you want with the piercer who – if they’re good – will encourage you to do so. It may also be helpful to discuss it with friends who have piercings. For men, the experience of the piercing can be quite intense and can lead to an endorphin rush and can be an essential part of the ritual. For others, it’s a sharp, intense feeling, but like with a tattoo, you only really feel it as the needle goes in.

Check list

Ask your GP if there are any reasons why you shouldn’t have a piercing (other than his/her thoughts on the matter).

If you need more than one visit to choose what you want, check over the clinic and discuss your needs with the studio – do so.

Believe it or not, there is no uniform standard in the UK. However, studios have to be registered in London with their London Borough and, elsewhere, they are usually registered with the local council (where they have to have a licence) or the health authority.

Set sufficient time aside, eg: it’s not a particularly intelligent idea to have a tattoo or piercing on your way to work!

Make sure the studio is covered by the appropriate health certification.

The studio should be scrupulously clean with separate waiting, tattooing/piercing, and sterilisation areas.

Get the studio to explain in advance the procedures involved and answer any questions.

After the tattoo/piercing, the studio should provide you with a written aftercare sheet.

If you have any doubts – follow your gut instinct and leave… you can always go back or find another studio.

Piercing after care

Remove dressing after four hours.

Clean with TCP antiseptic for two days only.

Continue to clean with pre-boiled water and salt.

Do not pull or tug jewellery.

Ensure that your hands are pre-cleaned using an anti-bacterial soap before touching your new piercing.

If you have any problems then contact your piercer for advice, this can usually eliminate a trip to your local GP.

Tattoos

The word, tattoo comes from the Tahitian word tattau, which means to mark, and was first mentioned in explorer James Cook’s records from his 1769 expedition to the South Pacific.

Some scientists have said that certain marks on the skin of a mummified human body dating from about 3300BC are tattoos. If that’s true, these markings represent the earliest known evidence of the practice. More widely recognised are tattoos found on Egyptian and Nubian mummies dating from about 2000BC.

Today, tattoos are created by injecting ink into the skin. The tattoo machine as we know it today has remained relatively unchanged since it was invented in the late 1800s and carries ink into your skin through a needle that moves up and down like a sewing machine.

Today’s machines puncture the skin at the rate of 50 to 3,000 times a minute. The sterilized needles are dipped in ink, which is sucked up through the machine’s tube system. Using an up-and-down motion to puncture the top layer of the skin they drive the ink into the skin, to about 3mm deep. What you see when you look at a tattoo is the ink that’s left in the skin after the tattooing. At this depth, cells of the dermis are remarkably stable so the tattoo’s ink will last, with minor fading and dispersion, for your entire life.

The size and type of your tattoo and the skill of the artist help determine the amount of pain involved. Pain also depends on the location of your tattoo: the lower back and ankle are popular places for tattoos, but it’s much less painful to get one on your chest or upper arm. This is because skin right above your bones tends to be more sensitive to needles while there’s extra body mass in the upper arm or chest to cushion the bones.

You should think carefully before getting a tattoo. A tattoo is to all intents and purposes permanent, and what you want when you are younger usually changes as you get older.

Tattoo removal is considerably more painful and expensive than tattooing. The process usually takes several sessions and offers varying results. Highly visible tattoos have been know to hinder career interests and plans. Speak to a friend who has a tattoo and ask him about his experience.

“Being able to blend into the background and remain covert is of paramount importance in our investigations. Any distinguishing features such as tattoos on your face, neck or forearms would make you more recognisable to someone who is under surveillance and would therefore make you unsuitable for this role.”Mobile Surveillance Officers Ref: 98 Job Description | MI5

Check list

Ask your GP if there are any reasons why you shouldn’t have a tattoo (other than his/her personal thoughts on the matter).

If you need more than one visit to choose what you want, check over the clinic and discuss your needs with the studio – do so.

Believe it or not there is no uniform standard in the UK. However, studios have to be registered in London with their London Borough; elsewhere they are usually registered with the local council (where they have to have a licence) or the health authority.

Set sufficient time aside, it’s not a particularly intelligent idea to have a tattoo or piercing on your way to work!

Make sure the studio is covered by the appropriate health certification.

The studio should be scrupulously clean with separate waiting, tattooing/ piercing and sterilisation areas.

Ask the studio to explain in advance the procedures involved, and answer any questions that you may have.

After the tattoo/piercing, the studio should provide you with a written after care sheet.

If you have any doubts – follow you gut instinct – and leave.

Tattoo after care

Remove any dressing after two hours.

Wash with warm soap and water and pat dry with a clean towel.

Do not recover the tattoo.

Do not get the tattoo contaminated with grease, dirt, paint etc.

Do not expose the tattoo to the sun.

Apply small amounts of Savlon cream to the tattoo for the first two days.

Nutrition

Our relationship with food

Our relationship with food is lifelong and influenced by friends, family, culture and years of programming. You only have to offer prawns to a White Brit for breakfast to see that our tastes are shaped by our heritage! So, whilst it’s tempting to suggest that food is simply fuel it’s actually far more complicated: what, when and why we eat is about more than fuelling our bodies.

Eating is also a social ritual: if you’ve ever been taken out for dinner then you’ll know that the meal was about much more than fuelling-up. Likewise, if you’ve ever reached for the ice cream after an argument, had chips because you felt like a treat, headed for the fridge because you were bored, or been so wound up you didn’t want to eat at all, then you’ll know that mood and food often go hand in hand.

We eat for fun, for comfort, for fuel and to socialise, and given that it’s a daily necessity, it’s hardly surprising that we can find ourselves in a love-hate relationship with the stuff. Nowadays, with one quarter of the UK adult population seriously overweight and eating disorders apparently on the rise, like it or not, finding ways to enjoy food and live well is more important than ever.

For some of us, our relationship with food and can get really tricky. Lots of us eat for comfort but find the relief it brings short-lived. It can be easy to get into a cycle of eating to feel better and feeling worse as a result: “I feel crap…” “I eat to comfort myself…” “I worry about putting on fat…” “I feel crap…” and so on. Similarly, some of us find ourselves in vicious cycles where we go on special diets in an attempt to sculpt our bodies, or to feel better about life, but end up finding things getting out of control. When things get out of hand in these ways and a pattern sets in, it’s time to wonder whether the problem has become an Eating Disorder.

Eating disorder myths

Let’s start by dealing with some of the common myths:

Myth 1: Only women get eating disordersThe truth is that men get eating disorders too! And that includes gay men. In fact, recent research suggests that eating disorders might be more of a problem for gay men than their straight counterparts.

Myth 2: People with eating disorders are stick thinActually, the majority of people with eating disorders are what would be considered a healthy weight (i.e. with a body mass index between 18.5 and 25). The stereotype might be of an emaciated woman but for many of us this stereotype means our problems go unnoticed.

Myth 3: Eating disorders are all about vanityWhilst eating disorders sometimes start with people’s attempts to look better, for many they are a response to stress, feeling out of control or being miserable. Anyone who has experienced it will tell you that having an eating disorder does not make them look good or feel good.

Myth 4: Eating disorders are all about foodAsk anyone with experience and they’ll tell you that eating is central to the problem, and also far less than the whole story. For men, driven exercise, burning calories and building muscle can be part of the picture too: and not necessarily in an attempt to look good, but simply to feel less bad. The issues can run deep: for some it’s about simply finding a way to feel ‘good enough’, or to cope with shame, whilst for others it can feel like a runaway train.

Myth 5: Guys with eating disorders are drama llamas who could eat normally if they just got a gripIf only it was this easy. When an eating disorder takes hold it leaves the person with very little control of their eating habits. Many who are dangerously underweight wish they could eat more but find themselves almost paralysed by the prospect. Likewise, many who binge find themselves feeling totally out of control and unable to stop.

Eating disorder facts

So, now you know about some of the myths, let’s move on to some of the facts.

Fact 1: Eating disorders are serious
Not only are they miserable to live with, eating disorders can be very serious. Research shows that people with eating disorders are more likely to die or to suffer ill health than those with almost any other mental health problem.

Fact 2: One in twenty people will have an eating disorder at some point in their life.
Whilst eating disorders are thought to be more common in women than in men, new evidence suggests that many men’s problems go unnoticed and that lots more guys are affected that was at first thought.

Fact 3: Men’s eating disorders are poorly understood and often go unnoticed.
Unfortunately, because of the focus on women, the problems men experience tend to be misinterpreted. Whilst some women’s problems grow out of a desire to lose weight, it’s common for men’s difficulties to start with plans to build muscle mass. Believe it or not, lots of the toned, beautiful, muscular guys you’ll see on the scene are struggling with eating problems.

Fact 4: If you’re a man with an eating problem it’s easy to feel like you’re on your own, but help and support are available: you just need to reach out.
If you need treatment for an eating problem then the place to start is with a trip to your GP. Not all GPs are good at spotting eating problems and some, rather sadly, believe in the myths so you may need to be clear with your GP that you have a problem and want a referral to an Eating Disorder Service. Your GP will then make the arrangements for you to see a specialist who will understand and know what to do.

What the body needs

In order for the body to function efficiently, it needs:

Protein for body growth, maintenance and repair. Protein also provides the raw materials for tissues and fluids and helps maintain the chemical balance in the brain, spine and intestine. Sources of protein include meat, dairy products, eggs, fish, chicken, pulses, nuts and seeds.

Carbohydrates provide the body’s main source of energy. Carbohydrates exist in two different types: simple sugars and complex carbohydrates such as starch. The majority of the diet should be made up of the latter. Sources of these include bread, pasta, rice, fruit, potatoes and other vegetables, and pulses.

Fat provides essential fatty acids for the production of substances such as hormones and cell membranes, and is also used as a concentrated energy source. Fat is found in most foods although butter, cheese, lard, margarine and oil all have high-fat contents.

Fibre has almost no nutritional value but has several key functions. It helps the digestive system absorb water from food and bulks shit so that it can pass more easily through the body. Foods containing fibre fill you up without piling on the calories. It can also help in lowering fat levels in the blood. Sources of fibre include whole grain bread, cereal, oats, fresh fruit and vegetables and pulses.

Vitamins are essential to tissue-building, hormones, nerve and muscle function and protection against illness and disease. Needed in small quantities, they are vital to the diet because they cannot be made by the body. Most foods are packed with vitamins but many of them increasingly lose their value the more the food is refined and cooked.

Minerals help regulate the body’s water balance, and the acidity level of body fluids. They assist in body growth and repair. Like vitamins, they are needed in small quantities but are usually found in most foods although they lose their value the more they are cooked.

Water is the body’s most important component, in that it makes up well over two-thirds of our bodies. All organs and tissues are dependent on water, and, without sufficient quantities, they will stop working. Blood, which is made up mainly of water, carries dissolved nutrients and oxygen to the body’s tissues and carries away waste products including carbon dioxide.

Calories

The basic unit for measuring energy is the scientist’s calorie. This is the amount of energy needed to raise the temperature of one cubic centimetre of water by 1°centigrade. When talking about food and human energy, the measurement most commonly used is the kilocalorie – 1000 times greater – often written as kcal or calorie. Kilojoule (kJ) is the international unit of energy. Approximately 4200 joules or 4.2 kilojoules is equal to one kilocalorie.

Food labelling

After decades of debate and wrangling, a new consistent system of front-of-pack food labelling was introduced in the UK in 2013. A combination of colour coding and nutritional information will be used to show how much fat, salt and sugar and how many calories are in each product. These measurements are also used to provide the nutritional information on the front of food packaging (eg: ready meals) and the side or back of food packets (eg: cereals)… though some of the information is printed in tiny tiny tiny writing which we think is very naughty.

A little bit about fats

Fats can be very confusing but in short some fats are better than others. We tend to eat too much saturated fat (present in meat and animal products) which can increase the risk of heart disease.

Current UK government guidelines advise cutting down on all fats and replacing saturated fat with some unsaturated fat (which comes from vegetable sources). In recent years, the popular media has turned the debate about the causes of major public health issues such as heart disease, diabetes and obesity into something of a ‘fat versus sugar’ dogfight. But the question should not be about choosing between fat or sugar: there are good reasons for cutting down on both.

A little bit about salt

Many of us in the UK eat too much salt. Too much salt can raise your blood pressure, which puts you at increased risk of health problems such as heart disease and stroke. Many processed foods are packed with salt, which contributes to high blood pressure. Try to avoid salty foods and choose lower salt versions whenever you can. When eating: don’t pile on the salt before even tasting it – it’s unhealthy and very rude!

A little bit about sugar

The instant ‘lift’ we get from sugar is one of the reasons we turn to it at times of celebration or when we crave comfort and reward. However, even those of us without a sweet tooth may be eating more than we realise because so many everyday, processed foods, from cereals and bread to pasta sauce and soups contain sugar.

But it’s not all bad news – sugar is a carbohydrate found naturally in a host of different foods from lactose in milk to the fructose in fruit and honey. In fact, we need some sugar in our diets to supply ready energy to fuel our muscles and keep our brains active.

There are two types of sugar – naturally occurring sugar like lactose in milk and added sugar, which includes table sugar (sucrose) as well as concentrated sources like fruit juice.

The problem is that many processed foods have added sugar which supplies energy in the form of calories – and very little else. This means our body has to draw on the nutrients from the rest of our diet to process it and this can affect our health, including our immunity – leaving us more prone to bugs and colds.

A high intake of sugar can lead to a feel-good ‘high’ which is often followed by a crashing slump leaving us tired, irritable and craving more sugary foods. It’s a vicious cycle that may be contributing to our weight problems as well as health concerns like diabetes and heart disease.

A little bit about fibre

Fibre is essential to the digestive system. It swells the bulk of food left after the nutrients have been removed, giving it shape and a dough-like consistency. Without it, your daily poo will come out slimy – like a wet fish, and diets with insufficient fibre can result in irritable bowel syndrome, constipation, haemorrhoids and piles.

Western diets tend to be low in fibre because we eat so much processed and refined food. Fibre comes from vegetables, high fibre breads and fruit and is the part of food that is not digested. It stays in your gut and is passed in poo stools (faeces) adding bulk.

You should aim to have 18-25g a day. Even if you’re on the go, there are easy ways to increase your fibre intake, although too much fibre can lead to constipation if taken with insufficient fluid.

Why is fibre important?

Poo stools are usually soft and easy to pass if you eat enough fibre, and drink enough fluid. We should aim to eat at least 18 grams of fibre per day. (The average person in the UK eats only about 12 grams of fibre each day.) A diet with plenty of fibre:

Will help to prevent and treat constipation

Will help to prevent some bowel conditions such as diverticular disease, piles (haemorrhoids) and a painful condition of the back passaged (anus), which is called anal fissure

May help you to lose or control weight. Fibre is filling but it has no calories and is not digested

May reduce the risk of developing bowel cancer

May help to lower your blood lipid (cholesterol) level

May reduce the risk of developing diabetes and help to control your blood sugar levels

Types of fibre

There are two types of fibre in the diet – insoluble fibre and soluble fibre. They work differently in the body. A combination of both types of fibre should form part of a healthy balanced diet in order to keep your gut healthy. Many foods containing fibre will naturally contain both types.

Insoluble fibre

This type of fibre is found in skin, pith and pips of fruit and vegetables, wheat and bran, corn (maize), nuts and whole grainsThis type of fibre cannot be dissolved in water. It passes through the digestive system mostly unchanged. It acts like a sponge and absorbs water, adds bulk to stools (faeces), and allows waste to be passed through bowels more quickly. This helps to prevent constipation and other conditions such as piles (haemorrhoids) and diverticular disease.

Soluble fibre

This type of fibre is found in oats, barley, psyllium and ispaghula, nuts and seeds, fruit and vegetables, and beans and pulses.This type of fibre does dissolve in water and can be broken down by the natural germs (bacteria) in the bowels. It softens stools and makes them larger, so that they are easier to pass. It also forms a gel in the stomach when mixed with water. The gel binds with excess cholesterol so it does not get absorbed, which helps to reduce the risk of heart disease. Also, soluble fibre helps to slow down the digestion of food; therefore, sugar (glucose – our main source of energy) is released and absorbed slowly. This keeps our blood sugar levels steady.

Fluid

Fibre needs fluid to work, so have lots to drink when you eat a high-fibre diet or fibre supplements. Drink at least two litres (about 8-10 cups) per day. This is to prevent a blockage of the gut, which is a rare complication of eating a lot of fibre without adequate fluid. This might include water, sugar-free squashes, herbal/fruit teas, tea and coffee.

Increasing fibre in the diet

You may find that if you eat more fibre or fibre supplements, you may have some bloating and wind at first. This is often temporary. As your gut becomes used to extra fibre, the bloating or wind tends to settle over a few weeks.

If fibre intake is suddenly increased, this can cause symptoms of wind and bloating. Introduce high-fibre foods gradually to allow the gut to become used to the extra fibre. Introduce one new food over a 2- to 3-day period. For example, have porridge for breakfast on the first day; then add beans or extra vegetables to a casserole two days later; then maybe have an extra piece of fruit 2 to 3 days later.

Some people report that a high-fibre diet causes some persistent mild symptoms such as mild pains and bloating. In particular, some people with irritable bowel syndrome find that an increase in fibre makes symptoms worse. But, this may be related to the type of fibre you take. It is probably soluble fibre rather than insoluble fibre that is most helpful, especially when aiming to ease symptoms of irritable bowel syndrome. Bran and other insoluble-based fibre may actually make symptoms worse in some people.

Tips for increasing fibre

Swap white bread for wholemeal bread

Swap refined cereals such as Rice Krispies® or Cornflakes® to wholegrain versions such as porridge or Bran Flakes®/ Weetabix®/ Shredded Wheat®

Nutrition tips

Making improvements to your diet can mean changing or breaking lifelong habits. Some of them may be difficult but they can be made

Changes don’t have to be wholesale. They should be gradual and easy to maintain

Set yourself realistic targets so that you are less likely to feel ‘on a diet’ or that you are being deprived of foods you want but can’t have

Eating more healthily is not a test, and punishing yourself for having ‘that cake’ serves no useful purpose and will only make you miserable

Don’t be tempted to miss meals. Current thinking suggests that you should eat five times a day: two healthy snacks between three main meals (breakfast, lunch and dinner), evenly spaced

Particularly, don’t miss breakfast: you’ll feel hungry all morning and be tempted to snack on unhealthy instant sources of energy.

When you’re shopping

Before you go decide what you’re going to eat, make a list and stick to it

Avoid the temptation to pick up foods which ‘look nice’ or are on ‘special offer’ – many of them will be packed full of sugar and fat

Don’t shop when you’re hungry

For guidance, read the nutritional information on foods – but don’t obsess!

Many foods today come in low or lower-fat versions. For example, if you drink full cream or whole milk, switch to semi-skimmed. There are also a wide range of low(er) fat yoghurts, cheeses and salad dressings

If you usually eat red meat, try chicken, turkey or fish instead

Ready-made meals can be packed with fat. If you’re buying them choose products containing no more than 5g of fat a serving

When you’re cooking

If you eat meat, trim off the visible fat and skin

Grill food rather frying

Avoid fried or sautéed foods

Don’t add salt

When you’re eating

Eat calmly, taking time to enjoy the food: savour the tastes and textures.

Chew your food slowly, rather shovelling it in and swallowing it whole.

Try to make mealtime a ‘no distraction’ time. Eat from the table and not your lap and resist the temptation to turn your meal into a TV dinner.

A glass of water with meals will aid digestion and make you feel more full

If you tend to pile your plate high – eat off a smaller plate. Eat until you are comfortably full – not bursting or bloated

Shovelling food can lead to indigestion and heartburn

Try to develop regular eating habits as this will help to regulate your appetite

Avoid piling on the salt and sugar.

And, if you’re eating out

Choose plain grilled meat, fish and poultry and avoid gravies and sauces made with cream or butter

Avoid the temptation to smother a healthy meal with butter or high-calorie sauces

If you feel brave enough, ask if lower fat versions of meals are available

By all means have wine with your meal but remember it’s not calorie free!

Exercise

Your heart

Just for a second, place your hand over your heart and feel it thumping. The heart is the body’s engine room, beating continuously as it pumps blood around the body. This remarkable organ is a true lifelong friend – all it asks in return is nutritious blood to pump around your body. Situated left centre of the chest, the heart is about the size of a clenched fist and weighs around 250g/8oz. As long as it is supplied with oxygen and nutrients it will go on contracting, spontaneously, rhythmically and completely automatically.

As you’re reading this, it’s beating between 50 and 90 times a minute, depending on your age, its condition and your level of fitness. During strenuous exercise, however, this may increase to about 180-200 beats a minute.

The heart is really two pumps. One receives oxygenated blood from the lungs and pumps it around the body. The blood leaves the heart through the aorta (which is the biggest artery in the body) and is distributed to all organs, tissues and cells through a succession of increasingly small tube-ways (capillaries). Compared to the width of the aorta (1cm), capillaries are tiny, barely half a millimetre across. Having delivered its oxygen and nutrients – and picking up carbon dioxide and waste products on the way back – blood returns to the heart via a system of veins.

The other pump receives de-oxygenated blood from the body and sends it to the lungs where carbon dioxide is exchanged for more oxygen. This complex network of arteries, veins, blood vessels and capillaries carry blood to and from the body in a continuous figure of eight circuit. Beating around 40 million times a year, each beat pumps around 0.15 litres (0.25 pints) of blood in and out of the heart – a staggering 9100 litres (2000 gallons) a day, or 227 million litres (50 million gallons) in a lifetime.

Blood pressure

Despite the fact we seem perfectly happy to stick out our arm, and have it wrapped up in an inflatable lilo – many men don’t know what their blood pressure is and what it means. Here’s a brief explanation. Blood pressure is the pressure created by the flow of blood through the main arteries. The pressure rises and falls as the heart responds to the demands we make upon it, for example exercise, anxiety and sleep.

Today blood pressure is usually taken using a digital blood pressure monitor machine though you might have it taken with a sphygmomanometer. Two measurements are taken: the systolic or higher pressure records the heart as it beats, pumping blood around the body, while the diastolic or lower pressure records the heart between beats, as it relaxes.

If you consistently have a reading of 140/90 or higher, you may have high blood pressure (hypertension). High blood pressure increases your risk of developing some health conditions, including cardiovascular disease.

Generally, the lower your blood pressure, the healthier you are. As a general guide, the ideal blood pressure for a young healthy adult is 120/80 or lower.

However, it’s possible to have abnormally low blood pressure. People with a reading of around 90/60 or lower are generally considered to have low blood pressure. For some people with low blood pressure, there may be an underlying cause that could need treatment.

Heart problems and solutions

If a kettle is not de-scaled regularly, it will fur up with lime scale, affecting its ability to boil water and contaminating hot drinks with white-grey flaky deposits. Similarly, a lack of exercise, an unhealthy diet, excessive alcohol and smoking will fur up the heart, arteries and veins with sludgy deposits of cholesterol and blood clots. This furring-up makes it increasingly difficult for the heart to function properly, causing it to beat irregularly, slow down or in extreme cases stop completely. The results can be life-threatening and include conditions such as high blood pressure, heart attacks, strokes and angina.

If you’re in your 20s, 30s or 40s, it’s unlikely you’ll give these illnesses a second glance… they happen to people you don’t really know. You may hear about them on the news, or perhaps see them mentioned in health leaflets when you visit your GP, but you’ll probably feel that don’t apply to you (not yet anyway). In many ways, heart disease is about death by stealth. It’s not until you get older that you find out that what you did – or rather didn’t do – when you were younger, has contributed to your first – and perhaps last – heart attack. While you’re partying away in your youth, you can also be laying down the foundations for a dead-cert heart condition later on.

By taking the following steps and integrating them into your life, you can significantly reduce the chances of developing circulatory problems, a heart condition or heart disease.

Give up smoking. Twenty cigarettes a day triple the risk of heart trouble.

Check your cholesterol level through your GP, particularly if your family has a history of heart problems.

Take regular exercise.

Lose weight (if you have excess weight to lose).

Get your blood pressure checked by your GP.

Drink sensibly. Current research suggests that a glass of wine per day can protect against heart disease, but excessive alcohol use leads to its own problems.

Starting exercise

There are many everyday opportunities to improve your level of fitness, but to begin with you should set yourself realistic goals. While many people start out hating exercise, most enjoy it sooner or later and learn to make it part of their everyday life. If you start exercising suddenly you will probably make yourself so stiff you won’t want to try again. You could also injure yourself.

So, if you’re a little (or a lot) out of shape, start slowly to allow your body time to become accustomed to the new demands you’re making on it. Even after a few weeks your ability to exercise will improve, and after a few months you should see an improvement in your stamina. A good way to introduce exercise into your life is to continue your everyday routine but in ways that require more energy. It’s a simple and easy process that means you don’t automatically have to join a gym or your local football club. Here are a few examples – which don’t cost a penny.

When you walk, walk a little faster.

Try a 15-30 minute walk, increasing it by a few minutes every week – as you feel able.

Use the stairs instead of the lift – especially if it’s only one floor up or down.

If you use escalators – walk up instead of standing still.

For short journeys walk or cycle instead of going by bus, underground or car.

Get off the bus or train a stop or two early and walk the rest of the way.

Choosing your exercise

The exercise you choose should aim to improve endurance (the ability to keep on exercising without stopping to rest), strength (the ability to use muscles to lift, carry, push and pull a load) and flexibility (the ability to stretch, bend or twist through a wide range of movements). Swimming and aerobics are good all-rounders promoting endurance, strength and flexibility; weight training focuses on endurance and strength, and jogging on endurance. Sex, on the other hand, provides an opportunity to improve your endurance, flexibility and strength and if you get it regularly, it’s a useful indicator as to your overall level of fitness.

However, there will be factors which may limit how fit you can become, such as your genetic make-up, your natural body shape, musculature, flexibility and metabolism. If you are naturally muscular you may be inclined towards the gym and weight training. Alternatively, if you have a sinewy or lean physique you may be more interested in jogging or running.

Other things to consider

The type of exercise or sport that you would like to do, eg: aerobics, walking, cycling, dancing, jogging, running, skipping, squash, swimming, tennis, joining a gym

Your short and long-term goals, eg: to have fun, make friends, get fitter and feel better, increase stamina, lose weight

How you are going to exercise, eg: by yourself, with a friend, as part of a team

When you will exercise, eg: frequency, the time of day, having sufficient time

Exercising safely

Anyone who exercises or plays sport regularly is bound to pick up the occasional injury. It probably won’t be serious, but exercising safely is important to ensure that you can keep on exercising while reducing the risks as far as possible.

Wear clothing that is comfortable and appropriate for the exercise or sport you are undertaking.

Before you start, do a five to ten minute stretching routine to prepare you for the exercise itself.

It may be helpful to seek professional advice from a coach, a more experienced person or manual.

Use protective equipment available for a specific sport.

Make sure that any equipment you works properly, and is the correct size.

Replace exercise shoes which have become worn or that don’t fit properly.

Don’t smoke, take alcohol or recreational drugs, or eat before exercising. Any of these could make you feel drowsy or dizzy or reduce co-ordination which in turn could lead to an accident or injury.

However, you may need an energy drink to raise your blood-sugar levels.

After exercise, cool down with muscle stretches and by continuing to move around for a few minutes to reduce stiffness and soreness.

Injuries, straining and illness

If you experience an injury or have any concerns or suffer any discomfort or pain, seek professional advice immediately. Most injuries (if you’ve not broken anything) involve minor damage to muscles, ligaments, tendons or the lining of a joint. If you have any injuries that remain painful or tender (or if you have any concerns about an injury) you should have them seen by your GP or a physiotherapist (or your nearest accident and emergency department if necessary). Always ensure that you follow to the letter any advice or treatment that you are given.

Danger signs that you might be straining your heart include pain in the chest, neck or arms, nausea, dizziness, light-headedness or feeling faint, severe breathlessness, extreme fatigue. Stop exercising if you suffer any of the above symptoms and get a check-up from your doctor before continuing. We all get ill from time to time and if you have a sore throat, temperature, swollen glands, a bad cough or mucus-producing cough, take a break from exercise until you feel better.

Getting active

Get out and active

Get out and active is a list of groups, activities and interests in London for gay men only or which are LGBT friendly. We update this section regularly but sadly cannot guarantee that all the information supplied here is correct.

V-W-X-Y-Z

The Bingham Cup

Mark Kendall Bingham Memorial Tournament or Bingham Cup is a biennial international, non-professional, gay rugby union tournament, first held in 2002. It is named after Mark Bingham, who died on board United Airlines Flight 93 when it crashed during the September 11, 2001 attacks.

Scrum is an award winning Australian documentary that tells a story of determination, acceptance, and brotherhood. Scrum presents an intimate look at the journey of three players on the Sydney Convicts Team as they prepare physically and mentally for the 2014 Bingham Cup. For these players, being part of the Convicts means you’re more than a team; you’re brothers. As the players vie for a place in the gay rugby World Cup, this muddy, sweaty and visually arresting documentary reveals what it means for these incredible tough men to be able to compete and be accepted for who they are.

Sleep

Sleep

We all have to sleep, and most of us will spend about a third of our life (approx. 250,000 hours) in a state of near unconsciousness, nonetheless aware of your environment. During this time, the body rests and undertakes maintenance and repairs.

Sleep is essential for promoting physical and mental health; when you sleep, blood pressure drops, breathing slows down and the body releases growth and sex hormones (although this is dependent on age). If you can manage on six hours’ sleep or less then you’re unusual; most men need around seven or eight hours, although we can usually cope with much less for a few nights.

Your sleep pattern is managed by your biological clock which co-ordinates other functions such as waking, sleeping, eating, pissing and shitting. It is thought this internal clock orchestrates the brain to stimulate and suppress various body systems. For example, it slows down piss and shit production until you wake up and are ready to go.

Without sleep the body cannot rest or repair itself and after about ten days of total deprivation, death occurs. The brain can adapt to periods of up to three days without sleep but eventually lack of sleep causes irritability, irrational behaviour, confusion and hallucinations.

REM, NREM and dreaming

When asleep, two distinct patterns alternate throughout this time: NREM – a deep, dreamless non-rapid eye movement sleep, and REM – when rapid eye movement occurs and you dream.

When you fall asleep you drift into NREM, spending about 90 minutes sinking through four levels and back up again. This is broken by a 10-15 minute burst of REM during which time the body is almost completely immobile except for the rapid flickering of the eyeballs.

The brain is almost as active as it is when you are awake, and this is when dreams occur. It is thought that dreams are the brain’s way of sorting through information and experiences gathered when awake. This pattern of sleep repeats itself throughout the night, although the last REM before waking up can last up to an hour.

During an eight-hour night, dreams take up about two hours, and although everyone has them, not everybody can remember them. If you’re woken up in the middle of REM you are likely to remember the dream vividly. However, if you’re woken up just five minutes after REM you will have a vague recollection of a dream; after ten minutes you’re not likely to remember any of it.

A good night's sleep

Whatever your ritual before you go to bed, try to develop a gentle and calming routine. Try to sort out insomnia naturally before considering sleeping tablets, which can leave you feeling groggy and disorientated in the morning. The following tips can help you get a good night’s sleep:

A firm mattress (rather than some stuffing with a dent in it) is less likely to give you back problems.

Ensure that the bed and linen provide suitable cover and warmth.

Open a window to ventilate the room. When it’s cold, even a couple of centimetres can help.

If you wear pyjamas (deepest sympathies) or some other clothing – make sure they’re comfortable.

If you’re worried or stressed, making a things-to-do list or mini action plan can help.

Have a warm bath or a shower to relax.

Go to the toilet if you need to.

Have a hot milky drink (a little ground nutmeg and honey is delicious).

Read, listen to the radio or watch TV until you drift off – assuming the programme doesn’t over stimulate the brain.

Some relaxing sex or a wank can help.

Have a glass of water by the bedside.

If you’ve been drinking try and drink a glass of water for each pint or spirit. While you run the risk of having to get up for a piss, you should feel less dehydrated and hungover in the morning.

Cuddle up to a hot water bottle (they don’t snore or fart).

Snuggle up to your man if he’ll let you!

Sleeping pills

If you have to take sleeping pills under your GP’s advice try a ‘natural’ variety from a health food store first. It is better to use pharmaceutical drugs only at times of serious or short-lived stress or emotional trauma.

Sleep and recreational drugs

Many recreational drugs like ecstasy, acid, coke, speed, GHB, mephedrone, and crystal meth are all likely to keep you awake and disrupt your natural sleep pattern.

Partying all weekend – without sleep – and then going to work on Monday morning will make you feel like shit and bugger up your sleep pattern further. You’ll go to bed shattered on Monday and wonder why you can’t get up on Tuesday.

After your drugs, set aside the next day to catch up on lost sleep even if it means taking Monday off to relax and chill out. Otherwise, the lingering effects of the drugs and the come-down can fuck up the whole week. If you don’t come down gently, the temptation is to take more drugs to help get over the wretchedness you can feel.

Mental health matters

Mental health matters

Mental health is about your emotional, psychological and social well-being. This includes how we think, feel, and act and also helps determine how we manage stress, relate to others, and make choices. Many factors contribute to mental health and problems which may occur, including biological factors, such as genes or brain chemistry; life experiences, such as trauma or abuse; and/ or family history of mental health problems.

According to the World Health Organization (WHO), mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. WHO stresses that mental health “is not just the absence of mental disorder”.

LGBT+ mental health

While attitudes towards LGBT+ mental health is improving many LGBT+ people have experienced difficulties in their lives. Being gay does not, in and of itself, cause mental health problems. Instead, homophobic bullying, rejection from family, harassment at work and poor responses from healthcare professionals are still commonplace for many lesbian, gay and bisexual people. Short answer: LGBT+ people are disproportionately affected by mental health issues.

The London Assembly Health Committee has published its findings and recommendations to the Mayor of London on how he can provide better mental health support for LGBT+ people. The report says

Up to one in ten Londoners (over 800,000 people) identifies as lesbian, gay, bisexual, transgender and/or other definitions of sexual orientation or gender identity

Around 40 per cent of LGBT+ people experience a mental health issue, compared to 25 per cent of the wider population

LGBT+ people are often overlooked when health commissioning decisions are made because of a lack of data and poor consultation.
Generic mental health services are not meeting the current needs of LGBT+ people

Without specialist support LGBT+ people will continue to experience mental health inequality, stigma and discrimination

Stonewall’s Gay and Bisexual Men’s Health Survey 2013 asked respondents a set of questions widely used by health professionals that help determine whether someone is experiencing depression or anxiety at that time and found that:

One in seven (13%) gay and bisexual men are currently experiencing moderate to severe levels of mixed depression and anxiety compared to 7% of men in general.

A further 9% of gay and bisexual men are experiencing moderate to severe levels of depression with mild or no anxiety compared to 2% of men in general.

Thus overall, 22% of gay and bisexual men are experiencing moderate to severe levels of depression.

Bisexual men are more likely to experience moderate to severe levels of depression (26%).

4% of gay and bisexual men are experiencing moderate to severe anxiety with mild or no depression.

In the last year, 3% of gay men have attempted to take their own life.This increases to 5% for bisexual men and to 5% for black and minority ethnic gay and bisexual men. In the same period, 0.4% of all men attempted to take their own life.

One in ten (10%) gay and bisexual men aged 16 to 19 have attempted to take their own life in the last year. One in sixteen (6%) gay and bisexual men aged 16 to 24 have attempted to take their own life in the last year. In the same period, 0.7% of all men aged 16 to 24 have attempted to take their own life.

In the last year, 27% of gay men thought about taking their own life even if they would not do it. This increases to 38% for bisexual men and 35% for black and minority ethnic gay and bisexual men. Just 4% of men in general thought about taking their own life in the last year.

Half (50%) of gay and bisexual men said they have felt life was not worth living compared to 17% of men in general. Almost half (46%) of gay and bisexual men who have felt this way did so in the last year.

With 6,861 respondents from across Britain, this is the largest survey ever conducted of gay and bisexual men’s health needs in the world. However, it demonstrates that many of those needs are not being met and that there are areas of significant concern – most particularly in mental health and drug use – that have been overlooked by health services which too often focus solely on gay men’s sexual health.

Through the Rainbow Lens | Kings College London | 11 Apr 2017 | 32m 53
In the summer of 2016 members of the LGBT+ community at King’s College London came together with researchers, service providers, film makers, and diversity and inclusion specialists, with the aims of exploring mental health issues affecting the LGBT+ community. This film is the result.

LGBT mental health support

London Friend counselling service provides one-to-one counselling sessions to LGBT+ people and for those who may be questioning their sexual orientation or gender identity. 12 weeks of counselling with a volunteer counsellor who is either fully qualified or working towards qualification/accreditation. All counsellors, supervisors and assessors work within the British Association for Counselling and Psychotherapy (BACP) code of ethics, or equivalent professional body. Counsellors who volunteer their time for London Friend all identify as lesbian, gay, bisexual or trans.

Financial contribution: As London Friend incur costs, such as building overheads and the provision of professional clinical supervision for counsellors, they invite people accessing the counselling service to make a regular financial contribution in accordance with their income. This would be discussed at your assessment.

The Metro Centre counselling service offers both short-term and long-term counselling, giving you an opportunity to explore, discover and clarify ways of living more resourcefully and with greater satisfaction. As a charity they do rely, to some extent, on contributions from the people who use their service. Each session costs them about £30 to provide and they do ask for a payment for each session. They are aware that everyone’s circumstances are different even when you are working, so anything that you can reasonably afford is most welcome. However, not everyone is working, so as a guideline they suggest a contribution of £3 per session if you are not waged. Please do not have any concerns over this as it can be discussed with the counsellor and a mutually acceptable agreement will be reached.

East London Out Project (EOP)020 8509 389856-60 Grove Road, Walthamstow, London E17 9BN

ELOP is a holistic lesbian and gay centre that offers a range of social, emotional and support services to LGBT communities, and our core services include counselling and young people’s services. Offers counselling service offers a low cost, confidential, high quality, and rapid response, self or third-party referral service for lesbian, gay, bisexual and trans people who have same-sex attraction and/or relationships, and others who may be uncertain but feel they could benefit from accessing a lesbian and gay service.

They also offer individual, couples and youth counselling.

Outcome020 7272 503835 Ashley Road, Islington, London N19 3AG

Tuesdays, 10.30am-4.00pm

Outcome @ MIND aims to provide a sanctuary for LGBT people – somewhere safe where they can be themselves, socialise free from discrimination, receive therapies to improve their mental health, learn new skills and acquire knowledge to improve their quality of life. Offers therapies such as psychotherapy, counselling, one-to-one and group art therapy and alternative therapies such as head massage and acupuncture throughout the day, as well as activities such as music tuition, drama, card making, a walking group, a film club, computer training and board games.

Pink Therapy020 7836 6647BCM 5159, London WC1N 3XX

Pink Therapy says its “the UK’s largest independent therapy organisation working with gender and sexual diversity clients. As an organisation we aim to promote high quality therapy and training services for people who are lesbian, gay, bisexual and transgender and others who identify as being gender or sexual diversities. There is a whole spectrum of different gender and sexual expressions and we welcome those who are engaged in consensual, albeit transgressive sexualities who are seeking a place to understand and be understood.”

Founded in 1985 PACE provided support services for the LGBT+ community for over 30 years delivering counselling, advocacy, training, youth work, research and mental health support services. A spokesperson for PACE said: “The decision to close the doors on PACE after 31 years of supporting the LGBT+ community is one that we have taken with a very heavy heart. The financial climate is very difficult for small charities, especially those delivering services at a local level with continuing cuts to local authority budgets. Sadly, despite work to support the charity, raising the necessary income needed has proved increasingly hard and it has become clear that it is no longer financially viable for the charity to continue. We would like to thank all those who have supported us and worked with us to deliver vital support services for the LGBT+ community. A very big thank you to all the staff and volunteers over the last 31 years who have provided so much support and dedication to the community.”

Helpline support

Switchboard
0300 330 0630

London Lesbian and Gay Switchboard (LLGS)
Welcome to Switchboard, a place for calm words when you need them most. We’re here to help you with whatever you want to talk about. We understand how anxious you might feel before you pick up the phone.
0300 330 0630 | 10am-11pm every day
LLGS PO Box 7324, London N1 9QS

MindOut is a mental health service run by and for lesbians, gay men, bisexual, trans, and queer people. Its online support service is an instant message service that is confidential, non-judgemental and anonymous. We are open every day including weekends and evenings. The service is run by trained online support workers and mental health advocates who are ready to provide emotional support, information or signpost you in the right direction. You can chat to us about whatever is on your mind, and we will always try and help in whatever way we can.

Samaritans | SamaritansLocal Drop-In Branches | Samaritans
You can talk to them any time you like, in your own way, and off the record, about whatever is getting to you. You don’t have to be suicidal. Every six seconds, somebody contacts them. They are there 24 hours a day, 365 days a year around the clock. They keep everything confidential and they are not a religious organisation.

LGBT Foundation
0300 330 0630

LGBT Foundation
We all need information and support from a friend in the know and LGBT Foundation’s Helpline Service provides thousands of hours of advice and support to thousands of people every year.
0300 330 0630 | 10am-10pm every day
LGBT Foundation, 5 Richmond Street, Manchester M1 3HF

ChildLine
Private and confidential service for children and young people up to the age of 19. You can contact a ChildLine counsellor about anything – no problem is too big or too small. Call them free, have a 1-2-1 chat online or send an email. Go to their website for more.
0800 1111 | Always open

ReThink Mental Illness 0300 5000 927

Rethink Mental IllnessWe provide expert, accredited advice and information to everyone affected by mental health problems. When mental illness first hits you or your family, it can be hard to know who or what to trust. We give people clear, relevant information on everything from treatment and care to benefits and employment rights. We were the first mental health charity to gain the Information Standard for our trusted and relevant information.
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Mental health books and articles

Straight Jacket | Matthew Todd

“Written by Matthew Todd, editor of Attitude, the UK’s best-selling gay magazine, Straight Jacket is a revolutionary clarion call for gay men, the wider LGBT community, their friends and family. Part memoir, part ground-breaking polemic, it looks beneath the shiny facade of contemporary gay culture and asks if gay people are as happy as they could be – and if not, why not?

In an attempt to find the answers to this and many other difficult questions, Matthew Todd explores why statistics show a disproportionate number of gay people suffer from mental health problems, including anxiety, depression, addiction, suicidal thoughts and behaviour, and why significant numbers experience difficulty in sustaining meaningful relationships. Bracingly honest, and drawing on his own experience, he breaks the silence surrounding a number of painful issues, explaining:

how growing up in the closet can overwhelm the gay child with a deep sense of shame that can leave young people with perilously low self-worth and a powerfully negative body image

how many gay men overcompensate for childhood shame by pursuing unobtainable perfection, aspiring to have perfect bodies, boyfriends and lives

how gay culture, so often centred around alcohol, drugs, quick sex and even quicker wit, exacerbates the problem, and what we can all do to make things better

Meticulously researched, courageous and life-affirming, Straight Jacket offers invaluable practical advice on how to overcome a range of difficult issues. It also recognizes that this is a watershed moment, a piercing wake-up-call-to-arms for the gay and wider community to acknowledge the importance of supporting all young people – and helping older people to transform their experience and finally get the lives they really want.” Penguin Books

Today’s gay man enjoys unprecedented, hard-won social acceptance. Despite this victory, however, serious problems still exist. Substance abuse, depression, suicide, and sex addiction among gay men are at an all-time high, causing many to ask, “Are we really better off?” Drawing on contemporary research, psychologist Alan Downs’s own struggle with shame and anger, and stories from his patients,

The Velvet Rage passionately describes the stages of a gay man’s journey out of shame and offers practical and inspired strategies to stop the cycle of avoidance and self-defeating behaviour. Updated to reflect the effects of the many recent social, cultural, and political changes, The Velvet Rage is an empowering book that has already changed the public discourse on gay culture and helped shape the identity of an entire generation of gay men. Da Capo Press

“Marriage equality and the changes in legal status were an improvement for some gay men,” says Christopher Stults, a researcher at New York University who studies the differences in mental health between gay and straight men. “But for a lot of other people, it was a letdown. Like, we have this legal status, and yet there’s still something unfulfilled.”

This feeling of emptiness, it turns out, is not just an American phenomenon. In the Netherlands, where gay marriage has been legal since 2001, gay men remain three times more likely to suffer from a mood disorder than straight men, and 10 times more likely to engage in “suicidal self-harm.” In Sweden, which has had civil unions since 1995 and full marriage since 2009, men married to men have triple the suicide rate of men married to women.

All of these unbearable statistics lead to the same conclusion: It is still dangerously alienating to go through life as a man attracted to other men. The good news, though, is that epidemiologists and social scientists are closer than ever to understanding all the reasons why.

Mindfulness

In a nutshell, mindfulness is about paying more attention to the present, than the past or future.

Its beginnings in Buddhist meditation, mindfulness has become a bit of a thing with a ton of guides, smartphone apps offering guided meditations, and counsellors and therapists keen to introduce you to its ways.

Our brain spends much of the time trying to plan, anticipate, and solve future which can lead to anxiety, stress and panic; eg:

an upcoming interview

a first date

moving home

coming out

money problems

The brain’s also pretty good at remembering the past. We play these things over and over in our mind which can lead to sadness, grief and depression; eg:

a relationship that didn’t end well

a painful coming out experience

a diagnosis

losing someone close to you

being bullied

Fixating on the past and/ or the future can add more crap to the real pressures of everyday life and our brains can often do both … all the time … and it can be exhausting!

Mindfulness interrupts this sort of thinking, allowing you to tune into what’s going on now (in the present moment) and not rehash the past, imagine things which haven’t happened yet, and/ or be overwhelmed by what’s going on around us.

It also involves thinking about your thoughts and feelings without judging them—without believing that there’s a “right” or “wrong” way to think or feel in a given moment.

Stress, anxiety and depression

Stress, anxiety and depression are closely related; sometimes they’re just different manifestations of the same problem. All of them arise to some extent from a difficulty in dealing with the pressures and demands that we face in everyday life – and although they’re hard work at the time, it’s important to remember that nearly everyone has suffered from some form of stress-related incident in their lives.

Stress is your response to the reality of a situation when demands outstrip your supply of physical and mental resources and (very often) time.‘My boyfriend and I seem to be drifting apart, but there’s never time to sit down and talk about it… I just don’t know what to do.’

Anxiety is the fear or apprehension you feel when you think something unpleasant is going to happen. ‘I’m worried my boyfriend’s seeing someone else and is going to leave… I have sleepless nights thinking about what would happen if he did.’

Depression is an overwhelming sense of negative thoughts about the past, present and future.‘My boyfriend left me last week and he’s taken most of the stuff. I feel lonely and can’t stop crying. Life’s just not worth living anymore.’

Stress and anxiety

If you’re always struggling to meet deadlines or coping with pressure, either at work or in your personal life, you may start suffering from stress. Here are a few things to look out for:

You work too hard and for too long

You have little or no time for rest and relaxation

You don’t get enough sleep

You don’t eat enough

You don’t exercise enough

Your friendships and relationships are suffering

Anxiety is caused by events, circumstances or situations which are threats, dangers or generate strong emotions. The body’s response is to release hormones such as adrenalin which bring about physical changes preparing us to work at maximum efficiency and which enabled our ancestors to attack wooly mammoths or run like hell. Today, this is known as the ‘fight or flight’ response. The body reacts in the following ways:

Blood sugar levels rise to provide energy

Our heart beats more rapidly and we breathe more deeply to increase oxygen supply to the muscles

We sweat to prevent overheating

Our pupils dilate to enable us to see better

Our stomachs churn and we need to shit to reduce body weight for running

Our balls pull themselves up into the body for safety

While the need to fight mammoths and marauding invaders no longer exists, the response to stress still exists and the threats have evolved. Our worries about where we’re going in life, and our feelings of insecurity and low self-esteem also fuel stress. Furthermore these threats rarely require us to ‘flee or fight’ and so anxiety tends to build up rather than get burned off running like hell or knocking the shit out of the enemy. The symptoms of anxiety are varied. Some happen immediately; others develop over time – weeks, months, even years.

Mental and emotional signs and symptoms

Inability to cope

Feeling of helplessness

Fear of failure (and success)

Fear of rejection

Poor memory

Inability to concentrate

Being easily distracted

Irritability

A build-up of emotions such as anger, jealousy and guilt

Cumming pre-maturely or not being able to cum at all

Dependence on alcohol, smoking, and recreational drugs

A feeling of impending doom

Physical signs and symptoms

Racing pulse and palpitations (unusually forceful heart beat)

Trembling and shaking

Sweating and flushing

Dry mouth

Lump in the throat

‘Pit’ in the stomach

Stomach pain and peptic ulcers (raw area in the stomach eroded by excess acid)

Loose shit / diarrhoea

Headaches, nausea, dizziness and faintness

Numbness, pins and needles

Aching muscles, eg: shoulders and neck

Eczema and skin conditions

Insomnia, tiredness and bad dreams

Depressed immunity with increased susceptibility to infections

High blood pressure

Angina (chest pain), stroke and heart attack

Compulsive or obsessive behaviour, eg: eating

Loss of appetite

Loss of interest in sex

Needing to piss often

When anxiety works

Anxiety is a perfectly normal reaction to a problem or a fear which cannot be resolved or doesn’t have an immediate solution. For example, you may feel mildly anxious starting a new job or very anxious if someone you care about has just received a positive HIV diagnosis. But no one would think they were extreme or out of proportion in the circumstances. While it might be distressing for your friends to see you so worried over the diagnosis of your friend or puzzling to see you worrying about the job, your reactions in both situations would be normal. Both these scenarios involve feelings about something which you think might happen: not getting on with your new work colleagues, for example, or fearing the death or illness of your friend. We use words and phrases like ‘…I’m feeling apprehensive’, ‘…dreading the worst’, or ‘…feeling nervous’. A certain amount of anxiety is part and parcel of life, whether it’s the financial difficulties, interviews, illnesses or losing your mobile phone.

Anxiety uses up energy and feeds on strong emotions, and that is not necessarily a bad thing. When a problem presents itself we can be motivated to make decisions, engage in practical activities and find a solution to deal with the problem. Anxiety can be a good thing insofar as, without it, lots of things would be left undone, and so a degree of stress in our lives is a motivator. Difficulties arise when we dwell incessantly on the result of a threat or problem, feel unable to prioritise the key components of a response, or cannot find a solution. Eventually, the anxiety is out of proportion to the circumstances. In severe cases we can cease to function at all.

Work and home lives are neglected either because we’re too anxious to start anything or we’re easily distracted by some other more worrying job. The fear of anxiety can attach itself to specific areas like agoraphobia or claustrophobia. Some people get panic attacks which trigger overwhelming anxiety, fear and dread. Before we know it we’re pacing up and down (or rooted to the spot), stomach knotted, and feeling as if the world is about to close in on us. An over-active thyroid gland and depression can mimic anxiety in younger persons and heart, lung and digestive problems may produce similar symptoms. However, the more symptoms you have – the more likely anxiety is to blame.

Managing and reducing stress and anxiety

Stress

The best way to deal with stress is to be positive and constructive, see situations in perspective, analyse problems logically and find realistic solutions. Easier said than done? Here are some suggestions:

Work out which situations and people cause stress and why; you may be able to make changes in a positive manner. Talk honestly – but sensitively – to those you see as being at the root cause of your troubles.

Change those things that can be changed, learn to accept those that cannot

Find solutions and make decisions as calmly as circumstances allow, and not under the pressure of deadlines

Break problems or tasks into bite-sized chunks and tackle them one step at the time

Set realistic targets and goals

Expect to make mistakes and don’t give up when the going gets tough. It’s all experience, learn from it and use it to your advantage

Talk more slowly and listen without interrupting

Learn to be patient and lose your great sense of urgency

Don’t say something will take two hours when it will take four, just to please someone. If it takes four, say so

Learn to value your strengths and acknowledge areas that need support – both are part of you

Don’t compare yourself to others; but if you feel there is a need – don’t be unfair on yourself

Don’t expect others to change before you are prepared to change yourself

Switch on the answerphone during breaks whether you’re doing the housework or between meetings

If symptoms of anxiety persist, or if you feel there is no noticeable improvement, it’s important to seek professional help. It’s certainly better to receive treatment early. Just talking through the issues with your GP may be enough. Alternatively therapy may be suggested to help you better understand and manage your anxiety. Admittedly it’s heavier stuff, but it’s about helping you to help yourself and not about carting you off to a hospital against your will! In some cases tranquillizers are prescribed as a short time measure to provide some ‘head space’ – however, they don’t deal with the root cause of your anxiety.

Regular exercise such as swimming, cycling, going to the gym or other non-competitive sport is essential in managing and reducing stress and anxiety effectively. Look at it as a modern day equivalent to the ‘fight or flight’ response: the body has primed you for activity – exercising will help you use this energy and reset your stress responses at a manageable level. A balanced and healthy diet will help you combat the effects of stress and anxiety. However, caffeine and nicotine mimic the body’s anxiety response and are best avoided when you’re under real pressure.

Tips:

Eat high-fibre whole foods

Lower your intake of sugar, salt and saturated fats

Eat little and often to prevent hypoglycaemia (low blood sugar levels) which also trigger the release of adrenalin and heighten the symptoms of stress

If you smoke, try to stop. In the short term, smoking may seem to quell your stress, but in the longer term it will magnify the harmful effects of stress on your health

Keep alcohol intake to within the safe maximum

Rest and relaxation

One of the most successful ways of dealing with stress is to make time for yourself, learn to relax and enjoy yourself.

Consider turning off your mobile phone once in a while, or switching on the answerphone

Set some ‘you’ time aside at home at least twice a week. Cook yourself a favourite meal or experiment with a new recipe. Look forward to a particular TV programme or watch a movie. Settle down with a book. Write a chatty letter or send a few e-mails. Relax in a candlelit bath.

Consider going to the cinema, theatre, exhibition, art gallery, market or local park. Doing at least one of these each week provides a varied programme of social activities.

Go out for a meal or invite friends round for a simple meal and fun company

Go for a walk to a part of town you’ve not been to before, perhaps visiting a landmark or tourist attraction

If you have a computer, spend some time exploring the internet (having checked out the costs – you don’t want to get stressed over a massive phone bill)

Make sure you give yourself a holiday at least once a year, and a weekend break at least twice a year. They don’t have to be expensive.

Depression

All of us have times when we’re unhappy, miserable, fed-up, pessimistic and feeling low, which usually comes about due to disappointment, frustration and loss. We sometimes rationalise it and call it ‘exhaustion’, ‘overdoing’ it or ‘nothing a club night won’t put right’. They’re reasonable things to say because we do get tired, we can overdo it and a night out might be just what we need to relax and let our hair down. Sometimes, this is depression.

Problems start when you start to feel this way more often than not. Little interest or enjoyment in life, feeling helpless and/or inadequate, feelings of loneliness and isolation and lack of motivation and drive are all examples of this. You may also have difficulty in making decisions, may no longer feel able to cope at work, and personal relationships are difficult and strained. You begin to feel that life isn’t worth living. Sometimes the cause is obvious: the end of a relationship, chronic money worries, a bereavement, unemployment or physical illness. However, depression can seem to ‘just happen’ which makes it difficult to comprehend.

Depression becomes an illness and requires medical attention or professional treatment when it won’t go away. Persistent warning signs and symptoms of depression include:

Lack of enjoyment of activities that are usually fun or enjoyable.

Poor concentration.

Inability to sleep properly, lying awake or waking up in the early hours.

Don’t drink alcohol to feel better – the immediate relief will only be followed by a deeper depression.

Take up a relaxation exercise.

Don’t cut yourself off from close friends. If you can, tell them the truth.

Not everybody can accept that they are depressed. It may not sit comfortably with how you see yourself or how you like others to see you: strong, masculine, in control. It’s a very male thing stemming from all the macho stuff we pick up in childhood, from family and on TV and film. Attitudes are starting to change for the better although many of us find it very difficult to show our feelings and emotions. Ironically, coming to terms with depression and acknowledging the need for treatment will probably be one of the truly brave things you will do in your life.

Professional help

Depression doesn’t usually just go away – its there for a reason although you may not know what the reasons are. You should seek professional help, and in the first instance, this is likely to be your GP. However, if you think or know that your depression is related to sex or your sexual health, speak to your sexual health clinic who may be able to provide support, counselling or a referral service.

If these steps are too much, phone one of the helplines listed below which may give you the confidence to see someone in person. Professional help is usually based on the idea of helping you to help yourself, and the appropriate counsellor or psychotherapist will encourage you to talk about your feelings and explore and confront the possible reasons for them. This can take weeks, sometimes months, occasionally years.

One of the problems with depression is knowing where to start particularly if you’re feeling de-motivated and apathetic. Anti-depressants can kick-start the recovery process and let a little light in. This allows you see that you can feel better, be more responsive to help and support and that further treatment will be beneficial. Unfortunately some anti-depressants have had a bad reputation because some of the older drugs have worked but have had side-effects such as drowsiness, blurred vision, heart irregularities, constipation and a dry mouth.

However, a new generation of anti-depressants called selective serotonin reuptake inhibitors (SSRIs) have fewer side-effects. It is increasingly accepted that depression can be caused by disordered biochemistry within the brain. Nerve cells (neurons) – which take information across the brain – communicate with each other using electrical signals. These signals have to jump tiny gaps between the cells called synapses but can only do so with the help of chemical neurotransmitters such as serotonin and noradrenaline which are thought to affect mood. Like ferries carry passengers across a river, neurotransmitters carry electrical signals across synapses. Fewer neurotransmitters mean fewer signals can take information across the brain and, in this instance, we can become depressed. SSRIs boost levels of neurotransmitters. Familiar brand names include Seroxat and Prozac.

Complementary therapies

Complementary therapies

Complementary and alternative and therapies can help to overcome stress and encourage relaxation. These include massage, acupuncture, herbal medicine, homoeopathy, yoga, reflexology, aromatherapy. Alternative therapies (eg: herbal medicine and homoeopathy) work in place of conventional diagnosis and treatment from your GP, whereas a complementary therapy (eg: reflexology and tai chi hu’an) works alongside this.

Alternative and complementary therapies have grown immensely in recent decades both in popularity and use. Complementary therapies aim to treat the individual as a whole person (holistically) to mobilise the body’s own defences. Many therapies use the idea of a ‘lifeforce’ and that health and contentment depend on achieving a harmonious balance of our physical, mental, emotional and spiritual natures.

Points to consider

Personal recommendation or word of mouth is a good way to find a practitioner

Check the practitioner is a member of the appropriate regulatory body or a professional association where no regulation exists

Therapists should be willing to provide a scale of fees

Therapists are unlikely to begin treatment without first building up a picture of you as an individual. Amongst other things, you are likely to be asked about your health, lifestyle and existing medications.

Therapists should be able to let you know how long it will be before you will see an improvement to your condition or problem

Session lengths will vary so give yourself plenty of time

Medicines will often originate from a natural plant, herb, oil or mineral, many of which will be available from pharmacies and health stores

Orthodox (traditional) drugs and complementary therapies can interact or interfere with each other. Make sure you keep your doctor and complementary therapy practitioner informed.

If you have any questions, eg: you’re uncertain which remedy to take, talk to a qualified practitioner

If you have an adverse reaction to your treatment, stop taking it immediately and seek advice

Acupuncture

Acupuncture revitalises the body by rebalancing the body’s flow of energy by stimulating the body’s ‘acu-points’ with fine needles. Factors believed to disturb the flow include poor diet, hereditary factors, infections, injuries, stress, emotional upset and the weather. Health problems that can respond well to acupuncture include painful arthritis, headaches, migraines, and neuralgia. Acupuncture can also help healing after fractures and sports injuries, and can alleviate depression and anxiety, drug addiction, allergies, sinusitis and conditions aggravated by stress. It can also assist people who feel run down but do not have any apparent physical illness or disease. Working on the same principle as acupuncture, acupressure provides an alternative for people who don’t like needles. The other advantage of acupressure is that you can learn to use it on yourself to treat minor ailments such as tiredness, constipation, headaches and colds. However, it is less precise than acupuncture and therefore results are usually slower.

Aromatherapy

The use of essential oils started as long ago as 2000 BC, but it wasn’t until the 1920s that the scientific study of their therapeutic properties and the term ‘aromatherapy’ came into being. Aromatherapy works primarily through the sense of smell that’s closely linked with mood, memory and emotions. It is recognised for its ability to lift the spirits and relieve stress and can also be used to ease pain and tension caused by tight and overworked muscles. In addition to the therapeutic effect of the fragrance, some essential oils are also believed to have healing properties.

Herbal medicine

Healing with herbs is one of the oldest therapies in the world and aims to restore the body to a state in which it is better able to heal itself. Herbal medicine can promote health by correcting imbalances within the body and encouraging your body to work as efficiently as possible. Treatments are likely to include recommendations about changing diet and lifestyle and reducing the amount of stress in your life.

Homeopathy

The principle of homeopathy is that ‘like cures like’ and that if a substance triggers symptoms similar to those from which a patient is suffering, then a small dose of that same substance will encourage the patient’s body to fight the illness or disease. Homeopathic remedies are derived from plants, minerals, metals, insects and recognised poisons, many of which have been used medicinally for generations. Homeopathy is believed to be suitable for many health complaints including depression and chronic conditions such as arthritis and post-viral fatigue syndrome.

Meditation

The aim of meditation is to revitalise the mind by resting it from continuously processing information and responding to the world around us. Meditation can improve your well-being, encourage more positive thoughts and feelings, lift self-esteem and help you to develop a more tolerant and stable attitude towards life. Research shows that people with stress-related conditions can derive great benefits from practising meditation. There are many ways to meditate; most involve sitting comfortably in a peaceful place and breathing rhythmically while focusing on a single thought or object. There are many groups where you can learn these skills; some are associated with religion others are secular.

Massage

Massage is probably the best known alternative therapy, possibly evolving out of our instinctive response to soothe aches and pains by rubbing the affected area. Massage is highly enjoyable and it can be very helpful in dealing with the physical and mental stress that life imposes on you. Massage can relax and tone the muscles, improve the flow of blood through the body, and encourage the removal of waste products and toxins. It can also reduce stress and increase your body awareness so that you begin to notice areas where you store tension.

Osteopathy

Osteopathy is recognised by many conventional doctors and is one of the more accepted complementary therapies. Osteopaths work on the muscles, joints and bones using massage and manipulation to improve the health of the whole body. By using manipulation to balance the tensions in the body structure and improving the functioning of the framework, it is thought to boost the health of the whole body. Conditions such as back disorders, slipped discs, neck pain and chronic muscular tension can benefit.

Reflexology

Reflexology works on the theory that health depends on the flow of energy within the body that begins and ends in the hands and feet. Medical conditions upset this flow. Reflexologists interpret the health and condition of the body and – by massaging certain reflex points – believe that it is possible to improve the health of body organs. Stress is thought to respond well to reflexology, which may be helpful in relieving tension, improving circulation, ridding the body of wastes, and re-balancing the body.

Shiatsu

Shiatsu literally means ‘finger pressure’ although therapists also use the palms and heels of their hands, their elbows and knees. Although Shiatsu cannot cure diseases, the symptoms of stress and stress-related conditions seem to respond to this therapy. People with asthma, muscular aches and pains, tension headaches, migraine, depression, insomnia and digestive problems can benefit. Shiatsu is believed to help in tuning a person’s general health and keeping the immune system at its best, making it a largely preventive therapy.

Tai chi

Tai chi (as it’s usually referred to in the West) is an ancient Chinese exercise system. It involves sequences of slow, individual movements, each with a symbolic meaning and name, which seek the natural harmony that surrounds and is in each person. As well as helping you to remain physically strong and supple, it can also centre the mind, putting it in touch with the body and encouraging a state of calm. Ideally you should learn from a teacher, but it is important to practise regularly, setting aside a specific time and place, preferably outside.

Yoga

Combining physical postures, breath control and relaxation, yoga provides a comprehensive workout for the mind and body. While some practise yoga as a way of working towards the ultimate goal of spiritual realisation, it is perfectly possible to do it simply as a means for relieving stress or improving overall health, with no special knowledge of the philosophy that lies behind it. The enormous advantage of yoga is that it can be safely undertaken by almost anyone, even those who are unfit or overweight. Yoga postures move all the major joints through a full range of motion, reducing stiffness and stretching and toning almost every muscle and tendon in the body. In the first instance, it is much better to go to a yoga class run by a properly qualified teacher than to attempt to learn yoga out of books.

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